Eye-tracking Measures Research Articles

Measuring Attentional Distraction in Children With ADHD Using Virtual Reality Technology With Eye-Tracking.

Objective:Distractions inordinately impair attention in children with Attention-Deficit Hyperactivity Disorder (ADHD) but examining this behavior under real-life conditions poses a challenge for researchers and clinicians. Virtual reality (VR) technologies may mitigate the limitations of traditional laboratory methods by providing a more ecologically relevant experience. The use of eye-tracking measures to assess attentional functioning in a VR context in ADHD is novel. In this proof of principle project, we evaluate the temporal dynamics of distraction via eye-tracking measures in a VR classroom setting with 20 children diagnosed with ADHD between 8 and 12 years of age.Method:We recorded continuous eye movements while participants performed math, Stroop, and continuous performance test (CPT) tasks with a series of “real-world” classroom distractors presented. We analyzed the impact of the distractors on rates of on-task performance and on-task, eye-gaze (i.e., looking at a classroom whiteboard) versus off-task eye-gaze (i.e., looking away from the whiteboard).Results:We found that while children did not always look at distractors themselves for long periods of time, the presence of a distractor disrupted on-task gaze at task-relevant whiteboard stimuli and lowered rates of task performance. This suggests that children with attention deficits may have a hard time returning to tasks once those tasks are interrupted, even if the distractor itself does not hold attention. Eye-tracking measures within the VR context can reveal rich information about attentional disruption.Conclusions:Leveraging virtual reality technology in combination with eye-tracking measures is well-suited to advance the understanding of mechanisms underlying attentional impairment in naturalistic settings. Assessment within these immersive and well-controlled simulated environments provides new options for increasing our understanding of distractibility and its potential impact on the development of interventions for children with ADHD.

Eye-Tracking Technology to Determine Procedural Proficiency in Ultrasound-Guided Regional Anesthesia.

Eye-tracking measures attention patterns, which may offer insight into evaluating procedural expertise. The purpose of this study was to determine the feasibility of using eye tracking to assess visual fixation patterns when performing an ultrasound-guided regional anesthesia procedure and to assess for differences between experienced, intermediate, and novice practitioners. Participants performed an ultrasound-guided sciatic nerve block 3 times on a fresh cadaver model while wearing eye-tracking glasses. Gaze fixation and dwell time on each location were compared between participants. Eye-gaze paths were used to derive a measure of entropy, or how often participants switched gaze fixations between locations. Five attending anesthesiologists, 5 third-year anesthesiology residents with prior ultrasound-guided regional anesthesia experience, and 5 medical students completed the study. Individuals with more experience were more likely to successfully perform the sciatic nerve block (5/5 attendings, 5/5 residents, 0/5 students; P = .002) and performed the procedure faster (average: attendings 62.6 seconds, residents 106.4 seconds, students 134.4 seconds; P = .089). Participants were progressively faster with practice (Trial 1: 41.8 seconds, Trial 2: 29.2 seconds, Trial 3: 28.9 seconds; P = .012), and the average number of eye shifts per trial decreased from 10.8 to 6.5 to 6 (P = .010). Attending physicians spent significantly less time fixating on the ultrasound monitor compared to trainees (P = .035). Average visual entropy progressively decreased from Trial 1 to Trial 3 (P = .03) and with greater experience (P = .15). There was a strong correlation between entropy and time on task (r(16) = 0.826, P = .001). Experienced providers make fewer back-and-forth visual fixations, spend less time in the procedure, and demonstrate less entropy during ultrasound-guided regional anesthesia procedures. Mobile eye-tracking has the potential to provide additional objective measures of performance that may help not only determine procedural competence but also distinguish between levels of proficiency.

RethinkingPowerPointSlide Design for Multimedia Learning

This analysis investigates two differential PowerPoint slide designs—presentation and teleprompter—for multimedia learning. Eye tracking measures assessed differences in fixations. Participants demonstrated greater fixation counts for teleprompter slides, measures of aesthetic liking evidenced that slides incorporating imagery resulted in more pleasurable learning experiences, and visually-based slides influenced more reflective learning and greater activation of information processing. The results offer practical advice for instructors wishing to increase the slide design effectiveness for improved multimedia learning.

Global reading processes in children with high risk of dyslexia: a scanpath analysis.

The study presents the first systematic comparison of the global reading processes via scanpath analysis in Russian-speaking children with and without reading difficulties. First, we compared basic eye-movement characteristics in reading sentences in two groups of children in grades 1 to 5 (N = 72 in high risk of developmental dyslexia group and N = 72 in the control group). Next, using the scanpath method, we investigated which global reading processes these children adopt to read the entire sentence and how these processes differ between the groups. Finally, we were interested in the timeframe of the change in the global reading processes from the 1st to the 5th grades for both groups. We found that the main difference in word-level measures between groups was the reading speed reflected in fixation durations. However, the examination of the five identified global reading processes revealed qualitative similarities in reading patterns between groups. Children in the control group progressed quickly and by the 4th grade engaged in an adult-like fluent reading process. The high-risk group started with the beginner reading process, then similar to first graders in the control group, engaged mostly in the intermediate and upper-intermediate reading processes in 2nd to 4th grades. They reach the advanced process in the 5th grade, the same pattern preferred by the control group second graders. Overall, the scanpath analysis reveals that although there are quantitative differences in the word-level eye-tracking measures between groups, qualitatively children in the high-risk group read on par with typically developing peers but with a 3-year reading delay.

Completing a Sustained Attention Task Is Associated With Decreased Distractibility and Increased Task Performance Among Adolescents With Low Levels of Media Multitasking.

ObjectiveTo assess distracted attention and performance on a computer task following completion of a sustained attention and acute media multitasking task among adolescents with varying self-reported usual media multitasking.MethodsNinety-six 13- to 17-year-olds played the video game Tetris following completion of a Go/No-go paradigm to measure sustained attention in the presence of distractors, an acute media multitasking, or a passive viewing condition. Adolescents completed the conditions on separate visits in randomized order. Sustained attention was measured within the Go/No-go task by measuring errors of omission. Distracted attention while playing the Tetris task was measured by computing eye tracking measures of attention (first fixation duration, cumulative fixation duration) to irrelevant distractor images that bordered the Tetris game. Participants also self-reported their daily media multitasking.ResultsThe Go/No-go task revealed important qualitative differences in sustained attention among low and high usual media multitaskers. There was a uniform improvement in sustained attention among low usual media multitaskers, demonstrated by a consistent linear decrease in omission errors (β = −0.01; P < 0.05). Among high usual media multitaskers, there was initially a decrease in sustained attention (β = −0.01; P = 0.05) followed by an increase (β = 0.16; P < 0.001). Completing the Go/No-go task also statistically significantly reduced distractibility and increased performance while playing Tetris compared to the passive viewing condition, but only among those with low usual media multitasking (all Ps ≤ 0.05). There was a non-statistically significant trend that completing the acute media multitask increased subsequent distractibility and performance while playing Tetris among high media multitaskers.ConclusionIn this sample of adolescents, practicing a sustained attention task reduces distractibility and improves task performance among those who have low levels of usual media multitasking.

The impact of mild traumatic brain injury on reading comprehension and eye movements: preliminary results

IntroductionIndividuals who sustain a mild traumatic brain injury (mTBI) can suffer from executive function, working memory, and attention deficits, which can impact functional task performance, including reading comprehension. Individuals with mTBI commonly report reading difficulties, but such difficulties have been historically difficult to capture using behavioral measures. The current study examined reading performance in those with and without mTBI using eye-tracking measures, which may be more sensitive to reading impairment in mTBI. Method/ResultsIn Experiment 1, 26 participants with a history of mTBI and 26 healthy control participants completed working memory (WM) and reading comprehension tasks. We found no differences in behavioral measures but found that spontaneous eye-blinking frequency was lower during the reading task in the mTBI group. In Experiment 2, we explored the impact of auditory distraction (e.g., multi-talker babble) on reading and memory performance. Twenty-three new participants with a history of mTBI and 26 healthy control participants completed a short-term memory (STM) task, a WM task, and a reading comprehension task under two distraction conditions. As in Experiment 1, we found no differences on behavioral measures, but observed significant differences on spontaneous eye-blinking frequency between those with and without mTBI. Group differences in distraction effects were also observed and performance on the WM task predicted reading comprehension performance. ConclusionsThe lack of differences on behavioral measures between groups, but lower frequencies of spontaneous eye blinking in the mTBI group suggests that while these individuals successfully completed the reading comprehension task, they may require more cognitive resources to do so.

Assessing infant cognition in field settings using eye-tracking: a pilot cohort trial in Sierra Leone

ObjectivesTo investigate the feasibility of eye-tracking-based testing of the speed of visual orienting in malnourished young children at rural clinics in Sierra Leone.DesignProspective dual cohort study nested in a cluster-randomised...

Different types of focus: Caregiver-child interaction and changes in preschool children's attention in two cultures.

Social contexts shape the development of attention; however, little is known about joint attention beyond infancy. This study employed behavioral and eye-tracking measurements to investigate cultural variations in how caregivers direct 3- to 4-year-old children's attention and subsequent changes in children's attention to objects and contextual backgrounds in the United States (predominantly non-Hispanic Whites) and Japan (N=60mother-child dyads, 29girls, 31 boys). The findings revealed that caregivers directed children's attention to culturally sensitive information, and significant cross-cultural differences in attention emerged after caregiver-child interaction, with Japanese children shifting their attention to the backgrounds. Results provide new insights into the role of social interaction and cultural diversity in the development of attention.

Parahippocampal deactivation and hyperactivation of central executive, saliency and social cognition networks in autism spectrum disorder

BackgroundThe concomitant role of the Central Executive, the Saliency and the Social Cognition networks in autism spectrum disorder (ASD) in demanding ecological tasks remains unanswered. We addressed this question using a novel task-based fMRI virtual-reality task mimicking a challenging daily-life chore that may present some difficulties to individuals with ASD: the EcoSupermarketX.MethodsParticipants included 29 adolescents: 15 with ASD and 15 with typical neurodevelopment (TD). They performed the EcoSupermarketX (a shopping simulation with three goal-oriented sub-tasks including “no cue”, “non-social” or “social” cues), during neuroimaging and eye-tracking.ResultsASD differed from TD only in total time and distance to complete the “social cue” sub-task with matched eye-tracking measures. Neuroimaging revealed simultaneous hyperactivation across social, executive, and saliency circuits in ASD. In contrast, ASD showed reduced activation in the parahippocampal gyrus, involved in scene recognition.ConclusionsWhen performing a virtual shopping task matching the performance of controls, ASD adolescents hyperactivate three core networks: executive, saliency and social cognition. Parahippocampal hypoactivation is consistent with effortless eidetic scene processing, in line with the notion of peaks and valleys of neural recruitment in individuals with ASD. These hyperactivation/hypoactivation patterns in daily life tasks provide a circuit-level signature of neural diversity in ASD, a possible intervention target.

Voice messaging while driving: Effects on driving performance and attention

The aim of this study was to analyze the performance and attentional effects of sending voice messages while driving as compared to calling and texting. To this end, participants were asked to drive a given path while they either receive a phone call, send voice messages, or send text messages on a given cell phone, as well as a control condition. Driving performance, eye tracking, and subjective measures were collected. The results showed that voice messaging, while not as detrimental to driving performance as texting, does lead to similar levels of visual and cognitive distraction as texting and is generally more distracting than calling. Drivers also seem to be unaware of the dangers of voice messaging while driving. This research provides the basis for improved guidelines and legislation and more targeted awareness campaigns that emphasize the dangers of voice messaging while driving on a level with other banned practices.

Response tendencies due to item wording using eye-tracking methodology accounting for individual differences and item characteristics.

The discrepancy of the scores on responses to negatively and positively worded items has led to hypotheses of inattention, confusion, difficulty, and differential processing of negatively worded items. The present study, utilizing eye-tracking methodology, aimed to fill an explanatory gap regarding response behavior, providing observations on the item-level response process. It experimentally examined characteristics of the items (wording type, self-relevance) and characteristics of the respondents (neuroticism, verbal abilities, and mood) for their impact on response outcomes. A sample of 87 university students completed a computerized version of a questionnaire with items presented in four alternative wording types: positive, negative, negated positive, and negated negative; half of the items referred to attitudes toward the self and the other half to attitudes toward others. Participants' eye movements during item completion were recorded with the Gazepoint-GP3-HD desk-mounted eye tracker. In linear mixed effects models, wording type and self-relevance were found to relate to response time, time of viewing and revisits to the body of the items and the response options, indicating that there were effects at the stages of comprehension and selection of response. Neuroticism was associated with differential item responses, suggesting a role in later levels of the response process, the retrieval, judgment, and response selection stages. Eye-tracking measures can enhance the examination of response tendencies with regards to item content, item wording, and person characteristics.

Visual behavior patterns of successful decision makers in crime scene photo investigation: An eye tracking analysis.

Crime scene investigation serves as an important source of information for law enforcement officers when running a case. Effective leads are uncovered based on the knowledge, technique, and experience of the crime scene investigator. This study utilized eye-tracking technology to understand different decision makers'visual behaviors and decision-making process when studying a crime scene picture. A total of 42 college students majored in crime investigation were recruited as the subjects of the study. Eye movement data were collected and analyzed using t-test and ANOVA on eye-tracking measures of areas of interest (AOI) for visual attention distributions as well as lag sequence analysis (LSA), heat map, and scan path observations for visual transfer patterns. The results showed that participants who made the correct decision were faster in identifying the key target. Regardless of whether they made the correct decision or not, their visual attention was fixated on the answer option of their choosing. Additionally, the subjects' attention must be shifted to the key target in order to make the correct decision. This study successfully applied the eye-tracking method to explore the investigation and decision-making process of inspecting a crime scene picture. Future studies can apply the eye-tracking method to deeply understand the process of information processing in investigating criminal scene pictures and provide more suggestions for professional training curriculum and instruction.

Oculomotor Behavior Predict Professional Cricket Batting and Bowling Performance.

Importance: A new, shorter version of cricket was introduced recently (Twenty20; T20). Since its inception, T20 cricket has rapidly become a popular and exciting format of cricket. However, there is little understanding of factors such as visual-motor control that influence expert performance.Objective: The purpose of this project is to determine if a series of oculomotor measures can predict batting and bowling performance in professional cricket players.Design: This study used a cross-sectional design. Each participant took part in a suite of eye-tracking tests to measure oculomotor behavior compared to their performance data.Participants: This study used a sample of 59 male T20 league professional cricket players (30 Bowlers and 29 Batsman).Results: One-way univariate analyses of variance examined the differences in oculomotor behavior between batsman and bowlers. A series of multiple regression analyses was conducted to evaluate how well the visual variables predict bowling and batting performance variables. Results demonstrate that several oculomotor eye tracking measures were good predictors of run performance and strike rate, including sports total score, sports on-field score, and sports functional score. Likewise, several of the same metrics predicted Runs and Wicket performance for bowlers. Overall, results provided further validation to a growing body of literature supporting the use of eye-tracking technology in performance evaluation.

Exploring the Associations between Reading Skills and Eye Movements in Elementary Children’s Silent Sentence Reading

The purpose of this study was to investigate the associations between elementary students’ reading skills and their online reading (i.e., real-time reading) behaviors during silent sentence processing. Thirty-five students participated in this study and their eye movements were recorded during sentence reading tasks. The effects of students’ reading skills measured by traditional standardized measures were investigated for widely-used eye tracking measures such as first fixation duration, gaze duration, regression path duration, total duration, word skipping, fixation count, and regression frequency. The eye tracking measures were chosen to represent early/late cognitive processes and temporal/spatial gaze behaviors. Linear mixed-effects regression analyses revealed that children’s performances in reading skills predict most of the eye tracking measures.

Look at the Audience? A Randomized Controlled Study of Shifting Attention From Self-Focus to Nonsocial vs. Social External Stimuli During Virtual Reality Exposure to Public Speaking in Social Anxiety.

Background: Enhanced self-focused attention plays a central role in the maintenance and treatment of Social Anxiety and is targeted in contemporary cognitive behavioral therapy. Actual developments use Virtual Reality (VR) for behavioral training. However, no VR attention training combining exposure to public speaking with shifting attention from self-focus to external focus has been investigated, and no experimental evidence exists on different kinds of external cues as targets of attention. Therefore, we investigated the effects of an attention training during public speaking in VR and examined differential effects of an external focus on nonsocial vs. social stimuli.Methods: In this randomized controlled study, highly socially anxious participants were instructed to focus on either objects or the audience within a virtual speech task. We assessed the pre-post effects on affective reactions, self-perception, and attentional processes during public speaking as well as general Social Anxiety using subjective, physiological, and eye-tracking measures. Repeated-measures analyses of variance (ANOVAs) were calculated to detect changes from pretest to posttest over both groups, and time × group interaction effects.Results: Within the analysis sample (n = 41), anxiety during public speaking and fear of negative evaluation significantly decreased, with no significant differences between groups. No significant time effect, but a significant time × group effect, was found for the looking time proportion on the audience members' heads. Follow-up tests confirmed a significant increase in the social-focus group and a significant decrease in the nonsocial-focus group. For all other variables, except external focus and fear of public speaking, significant improvements were found over both groups. Further significant time x group effects were found for positive affect during public speaking, with a significant increase in the social focus, and no significant change in the nonsocial-focus group.Conclusion: Our findings suggest that attention training to reduce self-focus can be successfully conducted in VR. Both training versions showed positive short-term effects in the highly socially anxious, with particular advantages of an external social focus concerning eye contact to the audience and positive affect. Further research should investigate whether social focus is even more advantageous long term and if reinterpretations of dysfunctional beliefs could be achieved by not avoiding social cues.

The Differential Impact of Mystery in Nature on Attention: An Oculometric Study.

Nature exposure can provide benefits on stress, health and cognitive performance. According to Attention Restoration Theory (ART), the positive impact of nature on cognition is mainly driven by fascination. Fascinating properties of nature such as water or a winding hiking trail may capture involuntary attention, allowing the directed form of attention to rest and to recover. This claim has been supported by studies relying on eye-tracking measures of attention deployment, comparing exposure to urban and nature settings. Yet, recent studies have shown that promoting higher engagement with a nature setting can improve restorative benefits, hence challenging ART’s view that voluntary attention is resting. Besides, recent evidence published by Szolosi et al. (2014) suggests that voluntary attention may be involved during exposure to high-mystery nature images which they showed as having greater potential for attention restoration. The current study explored how exposure to nature images of different scenic qualities in mystery (and restoration potential) could impact the engagement of attention. To do so, participants were shown nature images characterized by either low or high mystery properties (with allegedly low or high restoration potential, respectively) and were asked to evaluate their fascination and aesthetic levels. Concurrently, an eye tracker collected measures of pupil size, fixations and spontaneous blinks as indices of attentional engagement. Results showed that high-mystery nature images had higher engagement than low-mystery images as supported by the larger pupil dilations, the higher number of fixations and the reduced number of blinks and durations of fixations. Taken together, these results challenge ART’s view that directed attention is merely resting during exposure to restorative nature and offer new hypotheses on potential mechanisms underlying attention restoration.

Why subtitle speed matters: Evidence from word skipping and rereading

AbstractHigh subtitle speed undoubtedly impacts the viewer experience. However, little is known about how fast subtitles might impact the reading of individual words. This article presents new findings on the effect of subtitle speed on viewers’ reading behavior using word-based eye-tracking measures with specific attention to word skipping and rereading. In multimodal reading situations such as reading subtitles in video, rereading allows people to correct for oculomotor error or comprehension failure during linguistic processing or integrate words with elements of the image to build a situation model of the video. However, the opportunity to reread words, to read the majority of the words in the subtitle and to read subtitles to completion, is likely to be compromised when subtitles are too fast. Participants watched videos with subtitles at 12, 20, and 28 characters per second (cps) while their eye movements were recorded. It was found that comprehension declined as speed increased. Eye movement records also showed that faster subtitles resulted in more incomplete reading of subtitles. Furthermore, increased speed also caused fewer words to be reread following both horizontal eye movements (likely resulting in reduced lexical processing) and vertical eye movements (which would likely reduce higher-level comprehension and integration).

Spatial Neglect Midline Diagnostics From Virtual Reality and Eye Tracking in a Free-Viewing Environment.

Purpose: Virtual reality (VR) and eye tracking may provide detailed insights into spatial cognition. We hypothesized that virtual reality and eye tracking may be used to assess sub-types of spatial neglect in stroke patients not readily available from conventional assessments.Method: Eighteen stroke patients with spatial neglect and 16 age and gender matched healthy subjects wearing VR headsets were asked to look around freely in a symmetric 3D museum scene with three pictures. Asymmetry of performance was analyzed to reveal group-level differences and possible neglect sub-types on an individual level.Results: Four out of six VR and eye tracking measures revealed significant differences between patients and controls in this free-viewing task. Gaze-asymmetry between-pictures (including fixation time and count) and head orientation were most sensitive to spatial neglect behavior on a group level analysis. Gaze-asymmetry and head orientation each identified 10 out of 18 (56%), compared to 12 out of 18 (67%) for the best conventional test. Two neglect patients without deviant performance on conventional measures were captured by the VR and eyetracking measures. On the individual level, five stroke patients revealed deviant gaze-asymmetry within-pictures and six patients revealed deviant eye orientation in either direction that were not captured by the group-level analysis.Conclusion: This study is a first step in using VR in combination with eye tracking measures as individual differential neglect subtype diagnostics. This may pave the way for more sensitive and elaborate sub-type diagnostics of spatial neglect that may respond differently to various treatment approaches.

The effects of task-irrelevant threatening stimuli on orienting- and executive attentional processes under cognitive load.

Human visual attention is biased to rapidly detect threats in the environment so that our nervous system can initiate quick reactions. The processes underlying threat detection (and how they operate under cognitive load), however, are still poorly understood. Thus, we sought to test the impact of task‐irrelevant threatening stimuli on the salience network and executive control of attention during low and high cognitive load. Participants were exposed to neutral or threatening pictures (with moderate and high arousal levels) as task‐irrelevant distractors in near (parafoveal) and far (peripheral) positions while searching for numbers in ascending order in a matrix array. We measured reaction times and recorded eye‐movements. Our results showed that task‐irrelevant distractors primarily influenced behavioural measures during high cognitive load. The distracting effect of threatening images with moderate arousal level slowed reaction times for finding the first number. However, this slowing was offset by high arousal threatening stimuli, leading to overall shorter search times. Eye‐tracking measures showed that participants fixated threatening pictures more later and for shorter durations compared to neutral images. Together, our results indicate a complex relationship between threats and attention that results not in a unitary bias but in a sequence of effects that unfold over time.

The Potential of Naturalistic Eye Movement Tasks in the Diagnosis of Alzheimer's Disease: A Review.

Extensive research has demonstrated that eye-tracking tasks can effectively indicate cognitive impairment. For example, lab-based eye-tracking tasks, such as the antisaccade task, have robustly distinguished between people with Alzheimer’s disease (AD) and healthy older adults. Due to the neurodegeneration associated with AD, people with AD often display extended saccade latencies and increased error rates on eye-tracking tasks. Although the effectiveness of using eye tracking to identify cognitive impairment appears promising, research considering the utility of eye tracking during naturalistic tasks, such as reading, in identifying cognitive impairment is limited. The current review identified 39 articles assessing eye-tracking distinctions between people with AD, mild cognitive impairment (MCI), and healthy controls when completing naturalistic task (reading, real-life simulations, static image search) or a goal-directed task involving naturalistic stimuli. The results revealed that naturalistic tasks show promising biomarkers and distinctions between healthy older adults and AD participants, and therefore show potential to be used for diagnostic and monitoring purposes. However, only twelve articles included MCI participants and assessed the sensitivity of measures to detect cognitive impairment in preclinical stages. In addition, the review revealed inconsistencies within the literature, particularly when assessing reading tasks. We urge researchers to expand on the current literature in this area and strive to assess the robustness and sensitivity of eye-tracking measures in both AD and MCI populations on naturalistic tasks.