Early Identification of ASD: Translating Eye Tracking into Practice

自闭症谱系障碍 (ASD) 的早期识别：将眼动追踪转化为实践

基本信息

批准号：
9297357
负责人：
Karen L Pierce
金额：
$ 37.03万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-20 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9297357
关键词：
Algorithms Anxiety Attention Autistic Disorder Behavior Blinded Brain Characteristics Child Behavior Childhood Classification Clinic Clinical Communication Development Developmental Delay Disorders Diagnosis Diagnostic Disease Early Diagnosis Early identification Environment Eye Family Genetic Goals Grant Head circumference Heterogeneity Infant Laboratories Language Tests Maps Measures Methodology Methods Music Paper Parents Pattern Performance Phenotype Plant Roots Probability Proteomics ROC Curve Reporting Research Rest Risk Screening procedure Services Severities Social Behavior Specificity Speech Speed Standardization Subgroup Symptoms System Techniques Technology Testing Time Toddler Translating Translations Work base checkup examination clinical phenotype clinical practice computer monitor forest gaze improved innovation laboratory experiment neurobehavioral neuroimaging novel pediatrician portability preference public health relevance response satisfaction screening social sound tool

项目摘要

DESCRIPTION (provided by applicant): Currently, parent report screening tools (e.g., M-CHAT, CSBS) are the only standardized screening options available to pediatricians for the early detection of autism. As demonstrated in our previous work (the 1-Year Well-Baby Check-Up Approach, Pierce et al., 2011), such screens have valuable strengths, but also weaknesses, including the impact of parent characteristics on how they rate their child's behavior and high false positive rates. Autism is a disorder that has its roots in abnormal early brain development, yet early identification rests largely in the hands of parent report measures, rather than in the domain of more objective, quantifiable behavior. To move beyond parent report as the only early screening choice, novel procedures for screening must be researched. During our last grant cycle we developed a novel eye-tracking test, the Geometric Preference Test for Autism (GeoPref Test). This simple one-minute test shows dynamic, colorful geometric moving patterns on half of a computer monitor and colorful active people on the other half. Of >440 toddlers tested using standard eye tracking technology, almost every toddler who fixated at high rates on the geometric patterns was ASD, and not typical or developmentally delayed. Thus, our laboratory experiments demonstrated exceptionally high, 99%, specificity of the GeoPref Test for detecting ASD. A low false positive rate is essential in a screening tool because false positives overload the system and create anxiety. Equally important in this heterogeneous disorder, the 1-min test identified 37% of all ASD toddlers. This is a larger percentage than any other early genetic, proteomic, neuroimaging or neurobehavioral screen, and it is fast, easy, and highly ASD specific. Aim 1 will identify methods to integrate ASD specific test into clinical practice as a 2nd tier screen for babies who fail a routine 1st tier pencil and paper screen (i.e., the CSBS). Results will greatly improve the accuracy of early detection and speed referral of babies for diagnostic and treatment services. Using a portable eye tracker, 39 pediatricians will give the GeoPref Test in their office to toddlers who fail the CSBS who will in turn be referred to our Center for blinded diagnosis. This will be the first translation of an eye tracking finding on ASD into real-world clinical practice. In an effort to fully understand the clinical phenotype of ASD toddlers that "fail" the GeoPref Test, Aim 2 will use novel experimental tests, such as a test of exploration, as well as standardized tests such as the Mullen, to identify clinical profiles tha distinguish these toddlers from others with an ASD. Although the GeoPref Test identifies a large subgroup of 37% of all ASD toddlers, equally fast, and accurate tests are needed to identify the remaining ASD toddlers. Aim 3 proposes to develop new eye tracking tests, specifically novel social orienting and motherese paradigms, to detect these toddlers. Random forest classification algorithms will identify eye gaze signatures that best identify subgroups of ASD toddlers. All toddlers will receive a final blinded diagnosis at 30-36 months.

描述（由申请人提供）：目前，父母报告筛查工具（例如M-Chat，CSB）是儿科医生可用的唯一标准化筛查选项，可早期发现自闭症。正如我们先前的工作中所证明的（Pierce等人，2011年的1年良好检查方法），此类屏幕具有宝贵的优势，但也具有弱点，包括父母特征对他们如何评价孩子的行为和高误报率的影响。自闭症是一种疾病，其源于异常的早期大脑发育，但早期鉴定主要取决于父母报告的措施，而不是在更客观，可量化的行为的领域。要超越父母报告作为唯一的早期筛选选择，必须研究新的筛查程序。在上一个赠款周期中，我们开发了一种新颖的眼睛跟踪测试，即自闭症的几何偏好测试（GeopRef测试）。这个简单的一分钟测试显示了在计算机监视器的一半和另一半彩色活跃人员上的动态，多彩的几何移动图案。在使用标准眼迹技术测试的> 440个幼儿中，几乎每个以高速固定在几何模式上的幼儿都是ASD，并且不是典型或延迟的幼儿。因此，我们的实验室实验表明，用于检测ASD的GeopRef测试的99％特异性。较低的误报率在筛选工具中至关重要，因为假阳性使系统超载并引起焦虑。在这种异质性疾病中同样重要的是，1分钟的测试确定了所有ASD幼儿的37％。这是比任何其他早期遗传，蛋白质组学，神经影像或神经行为筛查的百分比都要大，并且它是快速，容易且特异性的。 AIM 1将确定将ASD特异性测试集成到临床实践中的方法，作为未通过常规第一层铅笔和纸屏幕的婴儿的第二层屏幕（即 CSB）。结果将大大提高婴儿对诊断和治疗服务的早期检测和速度转介的准确性。使用便携式眼动物跟踪器，39位儿科医生将在其办公室进行地理Ref测试，以使CSB失败的幼儿又将被引用我们的盲目诊断中心。这将是在ASD上发现的眼动追踪发现到现实世界临床实践的第一次翻译。为了充分了解“失败”地理REF测试的ASD幼儿的临床表型，AIM 2将使用新颖的实验测试，例如探索测试，以及诸如Mullen之类的标准化测试，以识别临床特征，以将这些幼儿与其他ASSD区分开。尽管GeopRef测试识别了所有ASD幼儿中37％的大型亚组，但仍需要快速，并且需要准确的测试来识别其余的ASD幼儿。 AIM 3建议开发新的眼动追踪测试，特别是新型的社会定位和母亲范式来检测这些幼儿。随机森林分类算法将确定最能识别ASD幼儿亚组的眼睛注视特征。所有幼儿将在30-36个月后获得最后的盲目诊断。