For whom does eye tracking track: A brief report on social attention as a precision biomarker for clinical trials in autism
5 affiliations
- 1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Corresponding author at: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA.
- 2Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA; Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- 3Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- 4Logan K Wink, MD, LLC, Cincinnati, OH, USA
- 5Division of Child and Adolescent Psychiatry, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, USA
Abstract
Autism spectrum disorder (ASD) is characterized by social communication impairments and atypical social attention, yet pharmacological interventions targeting these core symptoms remain elusive. Biomarkers such as eye tracking offer promise for improving outcome measurement in clinical trials; however, their utility may vary across autism clinical phenotypes. This pilot study examines whether eye-tracking sensitivity to treatment differs by baseline clinical characteristics in autistic adolescents and young adults enrolled in a randomized, double-blind, placebo-controlled, cross-over trial of intranasal (IN) ketamine. Twenty-one participants (ages 14–29) completed eye-tracking paradigms assessing proportion of looking to facial regions (eyes, nose, mouth) and social versus geometric scenes pre- and post-dose. Change scores from post-dose to pre-dose were correlated with parent-reported symptoms of social communication skills. Results revealed phenotype-dependent patterns: individuals with greater impairment in baseline social awareness shifted attention toward the eyes, whereas those with less impairment in their social awareness increased fixation to the nose. Fearful faces showed the broadest coupling with social communication skills, and increased geometric preference was associated with poorer social cognition. Findings underscore that biomarker informativeness is not uniform but interacts with individual clinical profiles, highlighting the need for precision measurement alongside precision medicine in autism clinical trials.
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BibTeX
@article{reisinger2026whom,
title = {{For whom does eye tracking track: A brief report on social attention as a precision biomarker for clinical trials in autism}},
author = {Debra L. Reisinger and Frederick Shic and Paul S. Horn and Logan Wink and Craig Erickson},
journal = {Biomarkers in Neuropsychiatry},
year = {2026},
month = oct,
doi = {10.1016/j.bionps.2026.100143},
url = {https://doi.org/10.1016/j.bionps.2026.100143},
note = {CC BY},
}
RIS
TY - JOUR
TI - For whom does eye tracking track: A brief report on social attention as a precision biomarker for clinical trials in autism
AU - Debra L. Reisinger
AU - Frederick Shic
AU - Paul S. Horn
AU - Logan Wink
AU - Craig Erickson
PY - 2026
DA - 2026/10/30
JO - Biomarkers in Neuropsychiatry
DO - 10.1016/j.bionps.2026.100143
UR - https://doi.org/10.1016/j.bionps.2026.100143
AB - Autism spectrum disorder (ASD) is characterized by social communication impairments and atypical social attention, yet pharmacological interventions targeting these core symptoms remain elusive. Biomarkers such as eye tracking offer promise for improving outcome measurement in clinical trials; however, their utility may vary across autism clinical phenotypes. This pilot study examines whether eye-tracking sensitivity to treatment differs by baseline clinical characteristics in autistic adolescents and young adults enrolled in a randomized, double-blind, placebo-controlled, cross-over trial of intranasal (IN) ketamine. Twenty-one participants (ages 14–29) completed eye-tracking paradigms assessing proportion of looking to facial regions (eyes, nose, mouth) and social versus geometric scenes pre- and post-dose. Change scores from post-dose to pre-dose were correlated with parent-reported symptoms of social communication skills. Results revealed phenotype-dependent patterns: individuals with greater impairment in baseline social awareness shifted attention toward the eyes, whereas those with less impairment in their social awareness increased fixation to the nose. Fearful faces showed the broadest coupling with social communication skills, and increased geometric preference was associated with poorer social cognition. Findings underscore that biomarker informativeness is not uniform but interacts with individual clinical profiles, highlighting the need for precision measurement alongside precision medicine in autism clinical trials.
SN - 2666-1446
ER -