Exploring Eye-Tracking Based Biomarkers to Assess Cognitive Abilities in Autistic Children: A Feasibility Study

Cognitive assessment can reveal a person's cognitive processing and behavioral patterns, making it an indispensable component of autism intervention and prognosis. Existing machine-assisted cognitive assessment methods primarily focus on children's performance outcomes, overlooking distinctive behavioral models, particularly characteristics of eye movement behavior, which have been demonstrated as the most direct indicators of cognitive abilities. In this study, we explore eye-tracking biomarkers for assisting cognitive assessment through a series of meticulously designed multi-level human-computer interaction protocols, encompassing three cognitive abilities: pairing and categorization, emotion recognition, and social interaction. A platform embedded with an eye-tracking module has been developed to reliably collect and analyze eye movement data, even in the presence of unrestricted large head movements in children. Experimental results indicate that there are significant group differences between autism and typically developing children in the eye-tracking features of total fixation duration, response latency, time to first fixation, mean fixation duration, and visit count in the absence of significant intergroup differences in the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and Wechsler Intelligence Scale for Children (WISC) assessment results. In addition, certain eye-tracking features in each group are correlated with WPPSI/WISC scale scores, enabling clinical cognitive assessments within each group based on these eye movement features. This study suggests that using eye-tracking features as biomarkers to assist detailed cognitive assessments holds significant potential for the intervention and prognosis of autism.