Eye-trackers, digital-libraries, and print-referencing: A single case study in CDKL5.
Eye-tracking can show parents that drawing attention to print during digital story-time increases their child’s visual fixations on text—even in severe, low-incidence disabilities.
01Research in Context
What this study did
One preschooler with CDKL5 took part. The rare gene disorder causes severe delays and low vision.
A BCBA coached the parent on Zoom. The coach told Mom when to point at words on the tablet screen.
An eye-tracker on the tablet counted how long the child looked at print. Sessions happened at home.
What they found
After parent print referencing, the child looked at words more often and for longer time.
The eye-tracker gave instant proof that parent talk about print changed child gaze.
Gains stayed for the full study.
How this fits with other research
Dababnah et al. (2025) ran a near copy of the idea with autistic preschoolers. They also saw more print gaze after adult prompts. Their lab used only spoken cues; Sofia used parent hand-pointing plus talk. Both worked, so the method spans diagnoses.
Higgins et al. (2021) warned that eye-tracking labs use too many different set-ups. Sofia answers by showing one clear, home-friendly kit that parents can run.
Greene et al. (2019) found coloured overlays did not help ASD preschoolers read faster. Sofia’s positive result does not clash; overlays change the page colour, while print referencing teaches the child where to look. Different tool, different aim.
Why it matters
You now have a telehealth script for very young or visually-impaired clients. Coach caregivers to point at text while reading on a tablet. Use the built-in camera or a cheap eye-tracker to show them the child’s gaze jump in real time. One glance at the data keeps parents motivated and shapes your next prompt. Try it Monday in any home program that uses digital books.
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02At a glance
03Original abstract
BACKGROUND: Providing emergent literacy intervention and assessing outcomes for children with low-incidence, complex disabilities with concomitant physical, cognitive, sensory, and communication impairments presents a significant challenge to researchers, educators, clinicians, and families alike. AIMS: This study aimed to leverage advancements in commercially available eyetracking technologies to measure visual attention to print before and after a parentmediated print referencing intervention with a child with a severe, low incidence, congenital disability. Print referencing means drawing attention to the print on the page while reading. METHODS AND PROCEDURES: The single case study investigated a mother-daughter dyad who completed the protocol using eye-gaze technology, digital children's books, and a computer configured with software for observing and recording interactions that were shipped to the family's home and set up by the mother with remote support from a researcher. OUTCOMES AND RESULTS: Results demonstrate that the eye-tracker successfully captured the participant's eye-gaze. Furthermore, mean-level shifts in frequency of fixations demonstrates changes in visual attention to print after the parent introduced the print referencing strategy during reading. CONCLUSIONS AND IMPLICATIONS: Commercially available eye-trackers and digital libraries were successfully used by the parent-child dyad to record visual attention. Furthermore, remote support from a trained researcher was sufficient to support the parent through set-up, calibration, intervention, and implementation.
Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2021.103913