EIRA (Eye-trackIng assessment for childRen with Autism)

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Aims and objectives:

EIRA aims to establish objective measures for identifying children with Autism Spectrum Disorders, using portable eye-tracking technology. The secondary aim is to assess the acceptability and feasibility of using this technology within community settings in Delhi, India. Ultimately, we therefore aim to discover a novel, acceptable, feasible and objective way to measure symptoms of autism in low resource community settings in Delhi, India.

Some background:

Autism Spectrum Disorders (ASD) is characterised by deficits of social communication and restrictive behaviours, and its diagnosis currently relies on highly skilled mental health professionals measuring these deficits. South Asia has the largest number of children with ASD in the world, however, although parents may notice symptoms as early as 24 months, large detection gaps mean that most children are belatedly or never diagnosed mainly due to the paucity of mental health specialists, hence critical years for interventions are missed. Current diagnostic assessments for ASD are complex, high-cost and require extensive training, therefore objective measures of ASD are needed for detection of ASD symptoms and behaviours.

Cognitive markers of ASD have been identified using eye-tracking technology, when tested in controlled lab-based settings in high-income countries. These markers have been associated with specific ASD symptoms when tested in childhood. EIRA therefore aims to establish markers using portable eye-tracking technology that are acceptable and feasible for use in identifying children with ASD in low resource settings in Delhi. Data is currently being collected in a case control study design in New Delhi in order to investigate these research aims. Such methods could improve detection of developmental disorders, and enable a greater number of children to benefit from early interventions.

How does this technology work?

A child sits in front of a screen watching videos of cartoons and people interacting (amongst other things); whilst the child watches these videos, we track where they are looking on the screen using a small portable eye-tracker. There is considerable evidence that eye-gaze patterns in children and people with autism differs compared to their typically developing peers, when looking at these specific tasks/scenes. However, this research has been almost exclusively conducted in highly controlled lab based settings in high income countries – this is the first study to bring this technology into a community setting in a low and middle income country, in order to understand whether these same differences can be seen in a much less well controlled environment.


EIRA is funded by a Sir Henry Wellcome Post-doctoral Research Fellowship awarded to Georgia Lockwood Estrin (Sangath, Birkbeck College, University of London – http://cbcd.bbk.ac.uk/people/scientificstaff/georgia-lockwood-estrin). Her Sponsors for this fellowship are: Prof Vikram Patel (Harvard University, Sangath) and Prof Mark Johnson (Birkbeck College, University of Cambridge). Collaborators include Dr Gauri Divan (Sangath) and Prof Sheffali Gulati (All India Institute of Medical Sciences, New Delhi).