Could an Eye-Tracking Test Aid Clinicians in Making an Autism Diagnosis? New Findings and a Look to the Future | Autism Spectrum Disorders | JAMA

Autism spectrum disorder (hereafter, “autism”) affects the ability to socially interact and communicate with others and is diagnosed in 1 in 36 children in the United States. The early course and clinical presentation of autism are variable, and differential diagnosis of young children can be challenging even for autism specialists. For example, one study found that only 60% of autism diagnoses were made with certainty in a sample of 478 toddlers and preschoolers who had been referred to specialists for an autism evaluation.1 In a 6-site study where diagnostic evaluations were conducted by experienced clinicians with 496 children aged 16 to 30 months referred to specialized centers, only 70.2% of diagnoses were made with a high level of certainty.² Thus, approximately 1 in 3 autism diagnostic evaluations of young children are associated with uncertainty. Children with higher cognitive and language abilities and milder autism-related behaviors are more likely to be missed and often receive their diagnoses later than those with greater language delays and more pronounced autism-related behaviors.² The high degree of diagnostic uncertainty for young autistic children contributes to delays in access to supports and services. Receiving an autism diagnosis is a first step to qualifying for early behavioral therapies that have been shown to improve outcomes, including language, cognitive, social, and adaptive skills.³