Oculomotor Function in Children and Adolescents with Autism, ADHD or Co-occurring Autism and ADHD.
Kids with autism plus ADHD show less precise eye movements than neurotypicals—oculomotor precision could become a low-cost biomarker.
01Research in Context
What this study did
Researchers tracked eye movements in three groups: kids with autism, kids with ADHD, kids with both, and neurotypical peers. They used a simple lab task that asked children to look at dots on a screen. The team measured how steady the eyes landed and how often extra tiny eye jumps occurred.
What they found
Children who had both autism and ADHD showed the wobbliest landing spots. Autistic children also made more 'catch-up' tiny jumps than typical peers. Kids with ADHD alone looked about the same as the control group. The differences were small but showed up on every trial.
How this fits with other research
Avni et al. (2021) saw no eye-movement gaps in preschoolers with autism. The new study looked at older kids and found gaps, so the skill may slip as children grow.
Martinez-Cayuelas et al. (2024) studied sleep rhythms in the same three groups and again saw the autism-plus-ADHD group stand out with the most disrupted markers. Together the papers build a picture: when autism and ADHD combine, subtle body systems drift further from typical.
Rosello et al. (2022) reviewed thirty-four studies and concluded that combined autism and ADHD brings compounded challenges. The eye data now add a quick, low-cost way to spot one more of those challenges.
Why it matters
You now have a five-minute eye task that can flag sensorimotor noise in kids with dual diagnoses. Use it during intake to add objective data to parent reports. If landing scatter is high, consider motor-based supports or referrals for vision therapy alongside your usual ABA plan. The measure is cheap, repeatable, and child-friendly.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a ten-trial eye-fixation check to your assessment battery and note landing scatter for clients with combined diagnoses.
02At a glance
03Original abstract
Oculomotor characteristics, including accuracy, timing, and sensorimotor processing, are considered sensitive intermediate phenotypes for understanding the etiology of neurodevelopmental conditions, such as autism and ADHD. Oculomotor characteristics have predominantly been studied separately in autism and ADHD. Despite the high rates of co-occurrence between these conditions, only one study has investigated oculomotor processes among those with co-occurring autism + ADHD. Four hundred and five (n = 405; 226 males) Australian children and adolescents aged 4 to 18 years (M = 9.64 years; SD = 3.20 years) with ADHD (n = 64), autism (n = 66), autism + ADHD (n = 146), or neurotypical individuals (n = 129) were compared across four different oculomotor tasks: visually guided saccade, anti-saccade, sinusoidal pursuit and step-ramp pursuit. Confirmatory analyses were conducted using separate datasets acquired from the University of Nottingham UK (n = 17 autism, n = 22 ADHD, n = 32 autism + ADHD, n = 30 neurotypical) and University of Kansas USA (n = 29 autism, n = 41 neurotypical). Linear mixed effect models controlling for sex, age and family revealed that children and adolescents with autism + ADHD exhibited increased variability in the accuracy of the final saccadic eye position compared to neurotypical children and adolescents. Autistic children and adolescents demonstrated a greater number of catch-up saccades during step-ramp pursuit compared to neurotypical children and adolescents. These findings suggest that select differences in saccadic precision are unique to autistic individuals with co-occurring ADHD, indicating that measuring basic sensorimotor processes may be useful for parsing neurodevelopment and clinical heterogeneity in autism.
Journal of autism and developmental disorders, 2025 · doi:10.1007/s00439-022-02496-z