Could an App Diagnose Autism in Children?

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The question is: are parents and other laypeople truly equipped, via the app, to make this kind of call?

A new study is looking at the possibility of an app to diagnose autism in kids. The app, which could be used on a cell phone, tablet or computer—would track eye movement patterns to determine, in 60 seconds, if a child is showing signs of autism spectrum disorder (ASD).

Poor eye contact—and a wondering gaze—is one of the key symptoms of ASD. The thinking: the earlier the ASD diagnosis, the earlier treatment can be implemented, creating a better long-term outcome. 

The question is: are parents and other laypeople truly equipped, via the app, to make this kind of call? To learn more, we talked to Jill Fodstad, Ph.D., a pediatric psychologist at Indiana University Health.

“There is a lot of interest and research right now focused on developing better ways to detect symptoms of autism at earlier ages,” says Fodstad. Research has shown that the earlier a child is diagnosed as having autism spectrum disorder (ASD) and begins therapy to address their symptoms, the better the prognosis.  “Given that, it would make sense that investigating a relatively low-cost and easy method, like an app on a cell phone, to assist with the detection of signs or behaviors indicative of autism would be investigated.” However, she cautions, while it could be good to develop a new front-line system to determine which kids are at risk for ASD, it’s important to realize the limitations of such an app.

For instance, can an app that tracks eye movements in kids accurately detect autism? “Eye tracking technology has been used for many years to study gaze behavior in various individuals,” Fodstad explains. Poor social eye contact is one of many core diagnostic symptoms of autism. “When eye tracking technology has been used with individuals with autism some studies have shown that those with autism look at social stimuli differently than those without autism, in particular looking less at the eye region of the face and more at the mouth region.” Hence an app that evaluates where a child looks at a picture could provide important feedback.

However, Fodstad stresses that eye contact is only one sign of autism.  “One positive symptom of autism does not necessarily mean the child has autism.”  Also, a child can have autism and not have problems making and maintaining eye contact.  “To be diagnosed with an Autism Spectrum Disorder, you also have to display other symptoms consistent with autism including certain language deficits, other social-communication impairments, and restricted or repetitive patterns of behavior or interests. Essentially this app could be helpful in detecting one symptom that many children with autism have, and allow parents to know if they need to follow up for further clinical evaluation.”

Second, Fodstad notes that current eye tracking technology is not free of errors. For an app to be able to be sensitive enough and be cost-effective for the general public, it may not be that precise - meaning children could be identified as having problems with eye contact but in the end not meet criteria for autism. “There can always be other reasons why a child may do poorly during the time they are using the app.  For example, children with ADHD and social anxiety have also been found to have difficulties with maintaining sustained eye contact.” Casting a wide net and identifying children at risk who end up not having autism could be viewed as a good thing, but for parents who are searching for answers this could lead to high levels of frustration.

Ultimately, Fodstad notes that it’s impossible for an app to diagnose autism, in part because it only detects one symptom. “I do see the utility of this type of technology in the future in assisting parents who have concerns to be able to easily determine if they need to seek additional help.  However, there is much research that still needs to be done.”

-- By Judy Koutsky 

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