Peer-reviewed article

Association between eye-tracking measures and Griffiths-III developmental scores at 18 months in healthy term-born children.

Sonia M Lenehan, Vicki Livingstone, John M O'Toole, Sean R Mathieson, Eugene M Dempsey et al. · 8 Oct 2026

Abstract

BACKGROUND: Current neurodevelopmental assessment tools strive to identify atypical development but have limitations. This study explored the potential of eye-tracking (ET) as an objective tool for assessing neurodevelopment at 18 months of age. METHODS: Healthy term-born children were prospectively recruited. At 18 months of age, participants underwent ET assessment and developmental assessment using the Griffiths Scales of Child Development-3rd edition (Griffiths-III). ET tasks assessed working memory, visual attention, and social cognition. Measures extracted from the ET tasks included first fixation, mean fixation duration, and saccadic reaction time. Pearson's correlation coefficients and multivariable linear regression analyses were used to examine associations between ET measures and Griffiths-III scores and subscales. RESULTS: Fifty-three children were included. The ET happy task (measures social cognition) showed the strongest correlation with Griffiths-III scales; mean fixation duration on the mouth was significantly associated with subscale A (Foundations of Learning) (r = 0.30, p = 0.03), subscale B (Language and Communication) (r = 0.57, p < 0.001), subscale D (Personal-Social-Emotional) (r = 0.37, p = 0.01) and overall General Development (r = 0.39, p < 0.001). In multivariable analysis, ET measures explained 36, 41, and 55% of variance in subscales A, B, and D, respectively. CONCLUSION: Eye-tracking measures, especially those measuring social cognition (Happy task) were associated with early language, social-emotional, and general developmental outcomes at 18 months of age. These findings support further investigation of ET as a complimentary objective approach for early neurodevelopmental assessment. IMPACT: Eye-tracking (ET) measures were associated with four of the five Griffiths-III subscales and overall General Development (GD) in a cohort of healthy term-born children. The strongest associations were observed between measures in the happy task and the Language and Communication subscale (Griffiths-III, subscale B). ET may provide complementary markers of early language, social cognition, and general developmental outcomes. Multivariable models combining ET measures explained variance in Griffiths-III outcomes, particularly in the Foundations of Learning, Language and Communication, and Personal-Social-Emotional subscales. Future research should focus on developing age-appropriate ET tasks with standardized scoring for the early assessment of language, communication, and social development.