Eye-gaze-driven games to support oculomotor skills in young adults with cerebral palsy using eye-tracking technology: a multiple case study.

A Game-Based Eye-Tracking Task for Inclusive Educational Assessment in Children with Autism Spectrum Disorder and Dyslexia: An Exploratory Study

Background: Inclusive educational assessment requires tools that capture how learners with diverse cognitive profiles engage with tasks. This study examines whether a game-based, gaze-contingent eye-tracking task can generate relevant indicators for inclusive assessment of autistic children and children with dyslexia. Methods: Forty-five children (15 autistic, 15 with dyslexia, 15 neurotypical) completed a Unity 3D eye-tracking task assessing implicit joint attention, inhibitory control, and task engagement. Six gaze-based metrics were analyzed alongside standardized measures of joint attention, theory of mind, working memory, and processing speed. Group differences in the eye-tracking metrics were examined using permutation-based analysis of covariance controlling for chronological age and Full-Scale IQ, and associations with clinical measures were examined using a small set of pre-specified, Holm-corrected Spearman correlations. Results: Significant group differences were observed for five of the six metrics (partial η2 = 0.33–0.81). The autistic group showed the highest values on difficulty-related metrics and differed significantly from both the neurotypical and dyslexia groups on nearly every measure, while the neurotypical and dyslexia groups did not differ significantly from each other. One correlation remained significant after correction for multiple comparisons: task efficiency in the autistic group was linked to a behavioral correlate of theory of mind. Conclusions: Gaze-based indicators within a game-based task can differentiate autistic children from neurotypical and dyslexic peers and show a preliminary behavioral correlate of theory of mind in autism specifically. These findings offer narrow, preliminary support for the value of process-oriented tools for inclusive educational assessment. Future research should examine feasibility, validity, and psychometric stability in larger, matched samples and in authentic school contexts.

Eye-tracking working memory intervention in young people with severe dyskinetic cerebral palsy: a pilot study.

Working memory (WM) is fundamental to learning, reasoning and everyday functioning and is frequently impaired in cerebral palsy (CP). In severe dyskinetic CP, profound motor and speech impairments limit access to reliable cognitive assessment and intervention. Eye-tracking technology may provide an accessible interface for computerised cognitive training. This study examined the feasibility and preliminary efficacy of adaptive eye-tracking WM training in four young people with severe dyskinetic CP (14-20 years; all female). Participants completed a 5-week intensive Cogmed training (five sessions/week) using the Light (n = 3) or Standard (n = 1) version. Tobii PCEye Mini eye-tracker was used for training; assessments were conducted at baseline, post-intervention and 3-month follow-up using Tobii Dynavox TD Pilot integrated with the Pearson Q-interactive platform. Near-transfer outcomes comprised Cogmed Improvement Index (trained WM) and Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) Picture Span score (untrained WM). Far-transfer outcomes included WISC-V fluid reasoning, visuospatial reasoning and planning; language comprehension using the Computer-Based instrument for Low motor Language Testing (C-BiLLT) and everyday executive functioning (Behaviour Rating Inventory of Executive Function-Second Edition) reported by parents and teachers. All participants completed 23-25 sessions within five weeks, corresponding to 100% adherence; mean session duration ranged from 22 to 34 min. Trained (+10.5 to +27) and untrained WM (+12 to +21) scores increased post-intervention, with gains largely maintained at follow-up. Far-transfer effects were inconsistent across participants. Adaptive eye-tracking WM training appears feasible in severe dyskinetic CP and may yield cognitive benefits. Larger controlled studies are needed to establish efficacy and generalisation of training effects.

Adapted Motor Activities for Hand-Eye Coordination in Level III Autism Spectrum Syndrome

Insights from Eye-Tracking Technology in Infants with or at Risk of a Motor Disability: A Systematic Review

Highlights What are the main findings? Eye-tracking can measure how infants, with or at risk of motor disabilities, interact with the world, including their attention, learning, and early communication skills. Infants at risk of a motor disability (e.g., preterm or with brain injury) often show slower visual responses and differences in attention, which may be detected using eye-tracking technology, even when standard clinical tests appear normal. What are the implications of the main findings? Eye-tracking could be a useful early detection tool to identify developmental delays, allowing earlier and more targeted support for infants at risk. There is a need for more consistent and standardized ways of using eye-tracking technology, so results can be compared and applied more reliably. Abstract Background/Objectives: Limited evidence exists on the use of eye-tracking technology in infants with disabilities, particularly with motor disabilities. This systematic review examines the eye-tracking metrics, protocols, and feasibility of eye-tracking technology in infants at risk or with a motor disability. Method: This systematic review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD42024563282). PubMed, Web of Science, CINAHL, ERIC, Embase, Scopus, MEDLINE, and the Tobii database were systematically searched, with two independent reviewers screening studies, extracting data, and assessing methodological quality using the Oxford Centre for Evidence-Based Medicine Levels of Evidence and Standard Quality Assessment Criteria. Results: A total of 15 studies were included with a total sample size of 667 (range 1–123), including 341 boys, 306 girls, and 20 infant genders unreported (M = 10.8 months; SD = 4.8; range 4–24 months). The infants included had brain injury as seen via MRI (4 studies), cerebral palsy (4 studies), or were born very preterm with varying risk factors (7 studies). In these studies, eye-tracking technology provided an objective measure of gaze patterns, gaze duration, fixation frequency, visual assessments, and saccades. Despite Tobii being the most common eye-tracking technology used, protocols varied by study design, duration, stimuli, metrics reported, and settings, making standardization challenging. Conclusions: Eye-tracking technology provides objective eye-tracking metrics that may be used to assess infant development. However, given the heterogeneity of studies, future research should follow standardized stimuli, protocols, and include diverse populations to make definitive conclusions and implications.

Task- and experience-dependent modulation of head-eye coordination during ball interception

Head-eye coordination during ball interception depends on both task demands and motor experience. The purpose of this study is to determine how these factors influence head-eye contributions to gaze control. Twenty-five female university students (novices with no ball sport experience, n = 13; experienced softball players, n = 12) performed two tasks: visually tracking an approaching ball (tracking task) and, in addition, moving the hand to the ball’s landing position (reaching task). Head, eye, and gaze velocities, cross-correlation coefficients between gaze and head velocity, and gaze-head lag time were analyzed using linear mixed models. The results showed that although gaze velocity remained unchanged regardless of tasks or groups, decomposing gaze into head and eye components revealed task-dependent contributions. Compared with the tracking task, the reaching task showed significantly larger head velocity and smaller eye velocity, indicating complementary adjustments that were not revealed by gaze movements alone. The cross-correlation between head and gaze was significantly higher in the reaching task than the tracking task, indicating stronger temporal coupling under greater task demand. Furthermore, the experienced group showed greater task-dependent modulation of eye velocity than the novice group, demonstrating greater flexibility in adjusting the magnitude of head-eye movements to task demands. In addition, the experienced group showed a consistently near-zero gaze-head lag regardless of task, whereas the novice group showed a prolonged gaze-leads-head interval. These findings suggest that ball sport experience shapes two distinct aspects of head-eye coordination: task-dependent flexibility in movement magnitude, and stable, temporally synchronized gaze-head control.

Skills-Transfer and Gaze Strategies Studied by Eye-Tracking: A Systematic Review

The ability to comprehend and interpret visualizations has garnered increasing attention in recent years. Individuals with specialized knowledge and experience in a particular field exhibit distinct patterns in how they perceive, process, and retain information related to that area. Extensive research across various domains has demonstrated that expertise confers perceptual and cognitive benefits in engaging with domain-relevant information. Eye-tracking methodology has provided significant insight into some of the perceptual mechanisms underlying performance differences between experts and novices in various professional settings, including aviation, car driving, medicine, arts, cartographic research and sports. The opportunity to access tacit expert knowledge, to improve efficiency of task performance and potentially to enhance safety measures has gained growing attention over the past years. This article conducts a systematic literature review to consolidate literature describing the application of gaze behavior as an adjunct tool to traditional teaching methods. Building on the proposed conceptual framework, we systematically reviewed the training potential of eye movements. Our results reveal that gaze-trained individuals exhibit a performance advantage over traditionally trained counterparts and that the impact and feasibility of expert skills transfer through gaze behaviors are moderated by different factors. We summarize the benefits of using expert gaze as a visual cue (e.g. EMMEs) in terms of attention-modeling processes, human performance and safety in work environment.