| Background Autism spectrum disorder(ASD)and attention deficit hyperactivity disorder(ADHD)are both neurodevelopmental disorders in early childhood and adolescence.Although these two diseases have different core symptoms,the additional symptoms of some cross manifestations and the characteristics of high co-morbidity make clinical diagnosis more difficult,which often leading to missed diagnosis or misdiagnosis.Objective This study will use eye trace technique to explore the characteristics and differences of each eye movement between ASD and ADHD,and to establish a diagnostic model of eye movement between ASD and ADHD,so as to assist early clinical diagnosis,provide objective diagnostic indicators,and reduce clinical misdiagnosis and missed diagnosis of the two diseases.Methods In this study,19 children with ASD and 33 children with ADHD were recruited from 6 to 12 years old as ASD group and ADHD group,and 31 typical developing children matched with ASD group and ADHD group in age and gender were recruited as normal control group.Eye trace technique was used to investigate whether there were different visual attention levels and eye movement tracks among ASD children,ADHD children and normal developing children,and to explore the visual search advantages and attention pattern characteristics of ASD and ADHD patients.Finally,combining the eye movement data of two experiments(visual search advantage experiment and attention pattern experiment),the most significant eye movement indexes were extracted for diagnosis and prediction so as to provide an objective and reliable evaluation method for early diagnosis and mutual differential diagnosis of ASD and ADHD on the basis of previous research results.Results(1)Visual search experiment The eye movement indexes of ADHD patients were significantly different from those of normal children,and the visual search ability of ADHD patients was worse than that of normal children.However,there was no significant statistic difference in the eye movement indexes between ASD and ADHD,ASD and normal children.(2)Attention pattern experiment(a)The eye movement indexes of normal children under eye-guided attention mode were significantly different from those of ASD and ADHD patients,and the attention of ASD and ADHD was worse than that of normal children.However,there was no statistic difference in eye movement indexes between ASD and ADHD.(b)Under the head-guided attention mode,there were significant differences in eye movement indexes between normal children and ASD patients,and the attention of ASD patients was worse than that of normal children.However,there was no statistic difference in eye movement indexes between ASD and ADHD patients,ADHD and normal children.(c)There was no statistic difference in eye movement indexes of normal children under the two guidance modes of eyes and head.There was no statistic difference in the indexes of eye movement under the guidance of eyes and head in patients with ASD.There are statistical differences in eye movement indexes of ADHD patients under the guidance of eyes and head,and the attention under the guidance of head is better than that under the guidance of eyes.(3)The indexes of eye movement with diagnostic value were screened out by logical regression analysis,and the models of diagnosis and differential diagnosis of ASD and ADHD were established.ASD diagnostic model,sensitivity was 82.4%,specificity was 84.4%,accuracy was 84.0%.ADHD diagnostic model,sensitivity was 71.4%,specificity was 72.4%,accuracy was 71.9%.Conclusion Visual search experiment can not distinguish ASD from ADHD.The single attention mode(eye guidance only or head guidance only)can not distinguish ASD from ADHD patients,but the preliminary differential diagnosis can be made by combining the two attention modes(eye movement guidance and head guidance).And the eye movement indexes screened by Logistic regression have high accuracy for the diagnosis of ASD and ADHD. |
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