Visual Attention Assessment in Early Autism Diagnosis

The results of clinical research published today in both the Journal of the American Medical Association (JAMA) and JAMA Network Open indicate that evaluating the visual attention of children can accurately predict an expert clinical diagnosis of autism in children aged 16 to 30 months with a remarkable degree of precision. Researchers from the Marcus Autism Center, affiliated with Children's Healthcare of Atlanta, emphasize that this innovative tool not only enables earlier autism diagnoses by clinicians but also provides objective assessments of a child's individual strengths and weaknesses, which can facilitate the initiation of valuable support for both the child and their family.

Warren Jones, Ph.D., the lead author and Director of Research at Marcus Autism Center at Children’s Healthcare of Atlanta, as well as the Nien Distinguished Chair in Autism at Emory University School of Medicine, stated, “The results show that the way in which young children look at social information can serve as an effective and objective biomarker for early signs of autism.”

The Marcus Test: A Test to Diagnose Autism at an Early Stage

In initial trials of this technology, researchers often referred to it as "the Marcus Test" for autism, recognizing the substantial contributions of philanthropist Bernie Marcus, who has been a key supporter of autism research and treatment for over 35 years, including the establishment of the Marcus Autism Center. A significant achievement in his lifelong work on autism has been the development of this tool to diagnose children earlier and get them into treatment sooner.

Autism affects 1 in 36 children, meaning that each year, more than 90,000 children with autism are born in the United States alone. Early identification and intervention are crucial for supporting the health, learning, and long-term well-being of all children with autism.

Over the past two decades, Dr. Jones and co-author Ami Klin, Ph.D., Director of the Marcus Autism Center at Children’s Healthcare of Atlanta have conducted research on "social visual engagement," examining how children observe and learn from their social surroundings, especially in children with autism. Past studies have shown that these differences emerge early in infancy and are closely linked to individual genetic variations. In their current work, Drs. Jones and Klin have developed technology to reliably measure these differences as a biomarker for clinicians (1^✔ ✔Trusted Source
Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016

Go to source).

Dr. Klin noted, “The far-reaching implications of these results may mean that children who currently have limited access to expert care, and face two or more years of waiting and referrals before finally being diagnosed at age four or five, may now be eligible for diagnosis between the ages of 16 and 30 months.” Additionally, this technology assesses each child's specific levels of social disability, verbal ability, and non-verbal learning skills, which is vital information for clinicians in developing personalized treatment plans to maximize each child's progress.

Clinical Studies of More Than 1,500 Children Show Efficacy of Visual Assessment Approach

Clinical studies involving more than 1,500 children have demonstrated the efficacy of this approach. Research published in JAMA Network Open outlines the initial development of the technology, with results from over 1,000 two-year-old children in discovery and replication studies. Data published in JAMA describe the outcomes of a multi-site trial at six of the nation's leading centers for autism diagnosis and treatment, where automated devices were used to assess approximately 500 children aged 16 to 30 months. In each of these studies, researchers evaluated whether automated measurements of children's looking behavior could accurately predict the results of diagnostic assessments conducted by highly trained, expert clinicians.

During the testing, children observed video scenes of social interaction, and their eye movements were monitored 120 times per second to determine their moment-to-moment focus on social information. Subsequently, tens of thousands of these measurements were compared to data from age-matched peers using algorithms to quantify similarities and differences at each moment in time. These measurements were then summarized to provide an overall diagnostic indication as well as individual measurements of each child's levels of social disability, verbal ability, and non-verbal learning skills.

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In comparison with expert clinical autism diagnoses at six of the nation's leading centers, automated measurements of children's looking behavior closely matched the current gold standard, potentially paving the way for earlier and more objective diagnoses in many children.

Dr. Jones remarked, “Objective, performance-based biomarkers can help clinicians diagnose and support more children and families, with the same level of clinical confidence. We hope this can alleviate current burdens on the healthcare system and reduce lengthy waitlists for assessment.” By shortening the time from a parent's initial concern to diagnosis and the commencement of beneficial support, this research has the potential to positively impact the lives of numerous children and families.

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Reference:

1. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016 - (https://www.cdc.gov/mmwr/volumes/69/ss/ss6904a1.htm)

Source-Eurekalert