# Discovering Eye Tracking Biomarkers of ASD with Diagnostic and Prognostic Power

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2021 · $722,691

## Abstract

Children with ASD, on average, are not identified and treated until around age 4‐years, several years beyond the
first signs and symptoms. Even when toddlers are diagnosed as ASD, parents and clinicians have little information
to guide treatment decisions or predict the early course of that child's next few years. Research is needed to
discover objective biomarkers that detect ASD at early ages with high accuracy, indicate disorder subtypes linked
to definable clinical profiles, and convey prognostic information. The discovery of such biomarkers have been
elusive, in part, because most studies utilize small sample sizes and fail to include non‐ASD delay contrast groups
which are essential to enhance specificity. Our proposal plans to fill this gap by leveraging eye tracking technology
to determine if visual fixation patterns in a large sample of very young (12‐36 months) ASD and non‐ASD toddlers
(n=225) from the general population can be used to discover an eye tracking biomarker profile of ASD. The
prognostic power of our eye tracking biomarkers will be determined by linking initial eye tracking scores to clinical
profiles 1‐2 years later. Given the heterogeneity in ASD, it is unlikely that a single eye tracking test would detect
all toddlers. Here we plan to remedy this by testing the utility of a battery of 9 developmentally appropriate,
short (~1‐minute each), eye tracking tests that each tap into a foundational domain in ASD symptoms including:
visual social attention, gaze shifting, and auditory social attention. Our tests will objectively quantify key metrics
such as overall fixation levels within social versus non‐social images, the frequency of gaze alterations during joint
attention and gaze following tests and, using unique gaze contingent technology, the degree to which a toddler
prefers to listen to prosodic, emotionally valent, motherese speech. Our preliminary findings suggest that several
of our proposed eye tracking tests have extremely high diagnostic accuracy. Findings, however, are sometimes
not replicated in science, and we proactively address this by proposing concurrent, independent and exact
(equipment, software, paradigms, procedures) replication testing of each of our eye tracking tests within an
independent cohort of toddlers at U. Washington (n=90 toddlers). Thus, in AIM 1 we will discover an eye tracking
biomarker that detects ASD at early ages (12‐36 months) with high accuracy using artificial neural networks at
UCSD, and then we will independently test replication of its performance at U Washington. To enhance
interpretability, our approach will incorporate patterns of metrics from each eye tracking test to produce an
Autism Risk Score (ARS) scaled from 0‐100 that represents the level of ASD risk for a toddler. In AIM 2, using a
rich clinical battery that captures each toddler's social, language, cognitive and symptom severity profile derived
from a combination of standardized, parent report, and free‐play testing, ...

## Key facts

- **NIH application ID:** 10063560
- **Project number:** 5R01MH118879-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Karen L Pierce
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $722,691
- **Award type:** 5
- **Project period:** 2019-02-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10063560

## Citation

> US National Institutes of Health, RePORTER application 10063560, Discovering Eye Tracking Biomarkers of ASD with Diagnostic and Prognostic Power (5R01MH118879-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10063560. Licensed CC0.

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