Early autism diagnosis - shaping the future with eye tracking

Prof. Dr. Karen Pierce describes her breakthrough findings enabling early diagnosis of autism spectrum disorder with the help of eye tracking technology.

Prof. Dr. Karen Pierce is a leading expert on the neural and clinical phenotype of autism spectrum disorder (ASD). Her early detection approach that focuses on mobilizing pediatricians, called the Get SET Early Model, has identified several thousand ASD toddlers around their first birthday, allowing them rapid treatment access. Using eye tracking and brain imaging technology within this early-detected population, Prof. Pierce’s work has revealed unusual patterns of eye gaze and brain activity that help elucidate the behavioral and biological heterogeneity of ASD.

About the interview

This video interview presents a conversation on autism and Prof. Pierce´s pioneering work in this field of research. What started as a research assistant assignment turned into a life-long passion and devotion to improving ASD treatment, as well as researching the biomarkers and devising innovative ways to diagnose the condition.

“My goal for my research is to discover early biomarkers of autism so that every child can reach their full potential. I hope that it’s going to be standard of care that most children with autism are identified between 12 and 24 months.”

Prof. Pierce describes her vision to enable early ASD diagnosis, allowing children timely access to treatment, and emphasizes that the work she had conducted toward that goal, enabled by the eye tracking technology, is the highlight of her career so far.

We talk about how different technologies complement each other in her work. Combining eye tracking and brain imaging (fMRI) has enabled her to reveal a striking relationship between visual attention preferences and brain activity in toddlers with ASD. In addition, she stresses the ease of use of Tobii eye tracking solutions, which has allowed her lab to empower undergraduate students to conduct experiments independently.

Delving further into the potential of eye tracking to enable early diagnosis of severe cases of ASD and customized treatment based on individual differences in visual attention, Prof. Pierce concludes that eye tracking is a great proxy, sharing that just a short test allows insight into the child´s clinical profile. Her findings lead us to envision a future where a quick eye tracking test at a pediatrician’s office would show parents whether their child could benefit from therapy years before conventional diagnosis permits.

“The biggest finding of my work is that eye tracking can be used to define subtypes of autism and diagnose different subsets of kids with very high accuracy...Eye tracking is really telling us quite a bit, not only about diagnosis but also potentially about prognosis and outcomes.”

We conclude the interview with valuable advice for creating new eye tracking paradigms, mentioning the challenges and considerations involved in starting off with eye tracking.

Watch the full interview to hear directly from Prof. Pierce about her visionary work.

Related information

Below you can find a selection of recent publications reporting on the work mentioned in the interview, which employed eye tracking technology:

Pierce, K., Wen, T. H., Zahiri, J., Andreason, C., Courchesne, E., Barnes, C. C., ... & Cheng, A. (2023). Level of Attention to Motherese Speech as an Early Marker of Autism Spectrum Disorder. JAMA Network Open, 6(2), e2255125-e2255125.

Wen, T. H., Cheng, A., Andreason, C., Zahiri, J., Xiao, Y., Xu, R., ... & Pierce, K. (2022). Large scale validation of an early-age eye-tracking biomarker of an autism spectrum disorder subtype. Scientific Reports, 12(1), 4253.

Xiao, Y., Wen, T. H., Kupis, L., Eyler, L. T., Goel, D., Vaux, K., ... & Courchesne, E. (2022). Neural responses to affective speech, including motherese, map onto clinical and social eye tracking profiles in toddlers with ASD. Nature Human Behaviour, 6(3), 443-454*.*

Bacon, E. C., Moore, A., Lee, Q., Carter Barnes, C., Courchesne, E., & Pierce, K. (2020). Identifying prognostic markers in autism spectrum disorder using eye tracking. Autism, 24(3), 658-669.

Kwon, M. K., Moore, A., Barnes, C. C., Cha, D., & Pierce, K. (2019). Typical Levels of Eye-Region Fixation in Toddlers With Autism Spectrum Disorder Across Multiple Contexts. Journal of the American Academy of Child & Adolescent Psychiatry, 58(10), 1004-1015.

For more on Prof. Dr. Pierce´s work, please visit the UC San Diego Autism Center of Excellence webpage.