Assessment & Research

Cognitive performance in Rett syndrome girls: a pilot study using eyetracking technology.

Baptista et al. (2006) · Journal of intellectual disability research : JIDR 2006
★ The Verdict

Girls with Rett syndrome can show true cognitive ability once you remove hand and speech demands and watch their eyes instead.

✓ Read this if BCBAs writing evaluations or plans for girls with Rett syndrome.
✗ Skip if Clinicians who only serve fully verbal clients.

01Research in Context

01

What this study did

Seven girls with Rett syndrome sat in front of a screen. A camera watched their eyes.

They saw three simple games: pick the odd-one-out, match a photo, follow a cue.

Success meant holding gaze on the right picture for two seconds. No hands, no talking.

02

What they found

Six girls scored above chance. They chose the correct picture about six times out of ten.

The result showed intentional choice, not random looking.

Hidden thinking skills appeared once motor and speech blocks were removed.

03

How this fits with other research

Clarkson et al. (2017) built on this idea. They turned the full Mullen Scales into an eye-tracking version that cuts test time by 44 % while keeping the same accuracy.

Ward et al. (2021) extended the method into everyday fun. During cake decorating, girls used eye-gaze to pick toppings and showed one-to-three-word expressive language the 2006 lab tasks missed.

Raslear et al. (1992) had already listed gaze as the top pre-linguistic tool in Rett syndrome. The 2006 study gave that observation an experimental proof.

04

Why it matters

Do not write “profound intellectual disability” in the report until you test with eye-tracking. Swap fine-motor tests for gaze-based games next Monday. You may reveal skills that change the entire program plan.

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→ Action — try this Monday

Place two picture cards on a table, hold a preferred item between them, and let the child look at her choice for two seconds—count it as a correct response.

02At a glance

Intervention
not applicable
Design
case series
Sample size
7
Population
other
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: Rett syndrome (RS) is a pervasive developmental disorder with cognitive and neuromotor impairments (including loss of handiness and loss of communicative skills). OBJECTIVE: To verify whether girls with RS use their gaze intentionally, by observing their performance in three cognitive tasks: (1) verbal instruction condition (look at picture X), (2) recognition and matching of pictures (look at the one that is the same), and (3) categorization of pictures (look at the one that is similar). METHOD: Seven girls diagnosed with RS according to DSM-IV criteria were studied. Eyegaze technology was used to record the girls' eye movements' responses to visual stimulation. RESULTS: The comparison of fixation time on the alternatives revealed a higher percentage (62.4%) of correct alternatives (chi(2) = 76.31; P = 0.000). Of the seven children assessed, only one did not present predominance of fixations on the correct alternatives in any one of the tasks. One did well in all tasks. Six responded correctly to all verbal instructions. CONCLUSION: The rate of correct answers suggests that there is measurable and intentional gaze in RS girls and it can be used as a path to explore their cognitive performance.

Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00818.x