Eye Tracking, ADHD, and Autism

Autism and ADHD are highly prevalent neurodevelopmental disorders with significant clinical overlap. Traditional diagnostic methods often rely on behavioral assessments, which can be protracted, especially when the conditions co-occur. The identification of objective biological markers, or endophenotypes of these disorders, could potentially enhance diagnostic precision and our understanding of etiology. 

Oculomotor function has emerged as a promising endophenotype for a range of neuropsychiatric disorders due to its quantifiable, reproducible, and heritable nature.

The recent research paper “Oculomotor function in children and adolescents with autism, ADHD or co-occurring autism and ADHD” by Forbes et al. (2025) highlights how precise oculomotor measurements, enabled by high quality eye tracking data, can potentially offer valuable insights into the underlying sensorimotor and cognitive processes in these populations.

Oculomotor Research into Autism and ADHD Method

The study by Forbes et al. (2025) investigated oculomotor function in a large cohort of 405 Australian children and adolescents (aged 4-18 years) with ADHD, autism, co-occurring autism + ADHD, or neurotypical development. This comprehensive study utilized an SR Research EyeLink 1000 eye tracker to collect precise eye movement data across four key tasks:

• Visually Guided Saccade (VGS) Task: Measures rapid eye movements to visual targets.
• Anti-Saccade (AS) Task: Assesses inhibitory control by requiring participants to look in the opposite direction of a presented target.
• Sinusoidal Pursuit Task: Evaluates smooth pursuit eye movements to a horizontally moving target.
• Step-Ramp Pursuit Task: Examines smooth pursuit onset.

Oculomotor Data Differentiates between Diagnostic Groups

The study revealed two distinct potential oculomotor markers:

• Final Eye Position (FEP) Variability in Autism + ADHD: Children and adolescents with co-occurring autism + ADHD demonstrated significantly greater variability in their FEP during the VGS task compared to neurotypical individuals. This suggests inefficiencies in sensorimotor control circuits, particularly those involving cerebellar-brainstem feedback loops crucial for saccade accuracy. Eye tracking’s ability to measure minute variations in eye position was fundamental to identifying this specific marker.
• Catch-Up Saccades in Autistic Individuals: Autistic children and adolescents exhibited a significantly greater number of catch-up saccades during the step-ramp pursuit task compared to neurotypical peers. This indicates reduced saccadic accuracy or difficulty in maintaining target tracking by matching eye velocity to target velocity in the early stages of smooth pursuit. The detailed temporal resolution of eye tracking allowed for the precise quantification of these corrective saccades, implicating both sensorimotor and corrective control processes.

These findings highlight how eye tracking provides objective, quantifiable data that can differentiate between diagnostic groups and pinpoint specific deficits in oculomotor control, which are often indicative of broader neurological differences.

The study underscores the importance of large, well-characterized cohorts and rigorous data processing methods, both of which are greatly facilitated by the capabilities of modern eye tracking systems. Future research will continue to leverage eye tracking to explore the neurobiological underpinnings of these differences and their links to broader symptomatology, contributing to more nuanced understandings and improved support for individuals with neurodevelopmental conditions.

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