CHEN Shaohe,ZHANG Yu,DING Ling, et al. Application of eye tracking technology in screening children with attention deficit hyperactivity disorder[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(10): 775-782.
Abstract：Objective: To explore the differences with eye-tracking technology in visuospatial attention,response inhibition, and eye movement control between children with Attention Deficit Hyperactivity Disorder (ADHD) and typically developing children, aiming to provide a more real-time and objective screening method for ADHD. Methods: A total of 140 children were selected from the Department of Child Health, Wenzhou People’s Hospital, from January 2023 to January 2024. Among them, 40 children were diagnosed with ADHD,and 100 healthy children (control group) were recruited during the same period. Eye-tracking equipment was used to detect participants’ eye movement while performing fixation tasks, saccade tests, and anti-saccade tests,including metrics such as average fixation duration, fixation number, and duration before first fixation, with a comparison of the differences in eye movement data between the two groups. Logistic regression analysis was used to assess the association between eye movement data and ADHD diagnosis and ROC curve analysis to evaluate the screening efficacy of various eye movement parameters. Results: Multivariate logistic regression analysis showed that in the fixation task, the average saccade duration in the ADHD group was significantly associated with ADHD diagnosis (OR=0.18, 95%CI=0.05-0.68, P<0.05). In the correct anti-saccade test, the time before first fixation was significantly associated with ADHD diagnosis (OR=0.96, 95%CI=0.93-1.00, P<0.05). In the erroneous anti-saccade test, the average fixation duration (OR=0.01, 95%CI=0-0.31, P<0.05), total fixation duration (OR=0.56, 95%CI=0.37-0.85, P<0.05), maximum fixation duration (OR=0.06, 95%CI=0.01-0.43, P<0.05), and the number of fixations (OR=0.83, 95%CI=0.71-0.98, P<0.05) were all significantly associated with ADHD diagnosis. ROC curve analysis showed that the AUC value of average saccade duration during the fixation task for ADHD screening was 0.697, the AUC value of time to first fixation in the correct anti-saccade test was 0.756, and the AUC values of average fixation duration, total fixation duration, maximum fixation duration,and number of fixations in the erroneous anti-saccade test were 0.716, 0.748, 0.733, and 0.722, respectively, all demonstrating good screening efficacy. Conclusion: Eye-tracking technology can effectively reveal differences in visual attention and eye movement control between children with ADHD and typically developing children,providing a new real-time, objective assessment tool for ADHD screening.
