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We tested whether\n                      <jats:italic>Gazefinder<\/jats:italic>\n                      autism assessment, with Classification Algorithm derived from gaze fixation durations, would have good accuracy (area under the curve [AUC]\u2009\u2265\u20090.80) to differentiate 2-4-year-old autistic from non-autistic children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Community sampling (March 2019-March 2021) of 2:00\u20134:11 year-olds included children recruited into a diagnosed Autism Group (\u2018cases\u2019) and Non-Autism \u2018Control\u2019 Group (with likely undiagnosed autism minimised). We recruited well beyond minimum necessary sample size to ensure within-group heterogeneity and allow exploratory subgroup analysis. Alongside\n                      <jats:italic>Gazefinder<\/jats:italic>\n                      eye-tracking attempted with all recruited participants, we collected parent-report measures for all children, and clinical\/behavioural measures with autistic children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      102 autistic (81.4% male;\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>age<\/jats:italic>\n                      <\/jats:sub>\n                      = 44mths;\n                      <jats:italic>SD<\/jats:italic>\n                      \u2009=\u20098.8) and 101 non-autistic children (57.4% male;\n                      <jats:italic>M<\/jats:italic>\n                      \u2009=\u200940;\n                      <jats:italic>SD<\/jats:italic>\n                      \u2009=\u200910.5) were recruited and eligible; the former slightly older, proportionately more male, and reflecting greater socio-demographic diversity.\n                      <jats:italic>Gazefinder<\/jats:italic>\n                      autism assessment was completed with 101 non-autistic children (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091 returning minimal data), and attempted with 100- and completed with 96 autistic children (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092 not attempted following adverse responses to clinical testing;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094 attempted but unable to calibrate). The Non-Autism Group returned significantly more overall tracking data. The final Classification Algorithm (range 0-100; threshold score\u2009=\u200928.6)\u2014derived from\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009196 children\u2019s fixation durations to elements of social\/non-social scenes, human face presentations, and referential attention trials\u2014had AUC\u2009=\u20090.82 (sensitivity\u2009=\u20090.82, specificity\u2009=\u20090.70). Compared to those correctly classified, autistic children misclassified as \u2018controls\u2019 showed greater overall tracking, and less pronounced autism features and developmental disability. Compared to correctly classified non-autistic children, those misclassified as \u2018cases\u2019 were older with lower overall tracking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Our groups differed on socio-demographic characteristics and overall tracking (included within the Classification Algorithm). We used the \u2018Scene 10A\u2019 stimulus set as provided, without update\/modification. Industry employees who developed the final Algorithm were non-blinded to child group, and considered only gaze fixation durations. Community sampling and \u2018case-control\u2019 design\u2014comparing diagnosed autistic vs. non-autistic children\u2014could be improved via future referral-based recruitment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Most children tolerated\n                      <jats:italic>Gazefinder<\/jats:italic>\n                      autism assessment, and our Classification Algorithm properties approached those reported from other\n                      <jats:italic>Gazefinder<\/jats:italic>\n                      use and established clinical assessments. Independent replication is required, and research informing the most suitable clinical application of this technology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ACTRN12619000317190<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13229-025-00670-4","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T14:29:13Z","timestamp":1752157753000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Accuracy of a 2-minute eye-tracking assessment to differentiate young children with and without autism"],"prefix":"10.1186","volume":"16","author":[{"given":"Kristelle","family":"Hudry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lacey","family":"Chetcuti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Weiting","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Aulich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A.","family":"Bent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherie C.","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodie","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Fordyce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Ninomiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Hakoshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J. 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Ethics approval from the La Trobe University Human Research Ethics Committee (HEC19027). Parents\/guardians provided signed informed consent for their child\u2019s participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Images included in Scene 10A animation were purchased or generated by JVCKENWOOD Corporation for use, including in open-access publication (and\n                      \n                      ) for illustrative purposes.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"M.N., A.S. and S.H. are employees of JVCKENWOOD Corporation, the developer and manufacturer of Gazefinder and funder of the current research. K.H. and A.J.O.W. received funding from JVCKENWOOD Corporation for the conduct of this research. L.C., D.W.T., A.C., A.A., C.A.B., C.C.G., J.S. and K.F. have reported no biomedical financial interests or potential conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"36"}}