{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:58:09Z","timestamp":1785560289657,"version":"3.56.0"},"reference-count":44,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001774","name":"University of Sydney","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001774","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/0384j8v12","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Limited evidence exists on the use of eye-tracking technology in infants with disabilities, particularly with motor disabilities. This systematic review examines the eye-tracking metrics, protocols, and feasibility of eye-tracking technology in infants at risk or with a motor disability. Method: This systematic review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD42024563282). PubMed, Web of Science, CINAHL, ERIC, Embase, Scopus, MEDLINE, and the Tobii database were systematically searched, with two independent reviewers screening studies, extracting data, and assessing methodological quality using the Oxford Centre for Evidence-Based Medicine Levels of Evidence and Standard Quality Assessment Criteria. Results: A total of 15 studies were included with a total sample size of 667 (range 1\u2013123), including 341 boys, 306 girls, and 20 infant genders unreported (M = 10.8 months; SD = 4.8; range 4\u201324 months). The infants included had brain injury as seen via MRI (4 studies), cerebral palsy (4 studies), or were born very preterm with varying risk factors (7 studies). In these studies, eye-tracking technology provided an objective measure of gaze patterns, gaze duration, fixation frequency, visual assessments, and saccades. Despite Tobii being the most common eye-tracking technology used, protocols varied by study design, duration, stimuli, metrics reported, and settings, making standardization challenging. Conclusions: Eye-tracking technology provides objective eye-tracking metrics that may be used to assess infant development. However, given the heterogeneity of studies, future research should follow standardized stimuli, protocols, and include diverse populations to make definitive conclusions and implications.<\/jats:p>","DOI":"10.3390\/children13081011","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:09:42Z","timestamp":1785398982000},"page":"1011","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Insights from Eye-Tracking Technology in Infants with or at Risk of a Motor Disability: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4938-2359","authenticated-orcid":false,"given":"Sabrina","family":"Schaly","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering, The University of Sydney, Sydney, NSW 2008, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5147-2487","authenticated-orcid":false,"given":"Annemarie","family":"Murphy","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Alliance, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0687-1098","authenticated-orcid":false,"given":"Darryl","family":"Chiu","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Alliance, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7597-6372","authenticated-orcid":false,"given":"Alistair","family":"McEwan","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, The University of Sydney, Sydney, NSW 2008, Australia"},{"name":"Cerebral Palsy Alliance, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6253-9488","authenticated-orcid":false,"given":"Petra","family":"Karlsson","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, The University of Sydney, Sydney, NSW 2008, Australia"},{"name":"Cerebral Palsy Alliance, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref_1","unstructured":"Spittle, A., Orton, J., Anderson, P.J., Boyd, R., and Doyle, L.W. (2025, December 05). Early Developmental Intervention Programmes Provided Post Hospital Discharge to Prevent Motor and Cognitive Impairment in Preterm Infants|Cochrane Library. Available online: https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD005495.pub4\/full."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100049","DOI":"10.1016\/j.gpeds.2023.100049","article-title":"The key 1000 life-changing days","volume":"4","author":"Indrio","year":"2023","journal-title":"Glob. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bayley, N. (2012). Bayley Scales of Infant and Toddler Development, Third Edition. PsycTESTS Dataset, American Psychological Association.","DOI":"10.1037\/t14978-000"},{"key":"ref_4","unstructured":"Voress, J.K., Maddox, T., and Hammill, D.D. (1998). Developmental Assessment of Young Children, Pro-ed."},{"key":"ref_5","first-page":"S46","article-title":"Construction and validation of the Alberta Infant Motor Scale (AIMS)","volume":"83","author":"Piper","year":"1992","journal-title":"Can. J. Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/S0163-6383(02)00150-9","article-title":"Variability and infant development","volume":"25","author":"Siegler","year":"2002","journal-title":"Infant Behav. Dev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Moradi, S., and M\u00f8ller-skau, C. (2025). Subjective measures of disability in children and adolescents: Opportunities, challenges, and implications. Front. Rehabil. Sci., 6.","DOI":"10.3389\/fresc.2025.1531740"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1093\/jpepsy\/jsy068","article-title":"Psychometric Properties of Assessments of Cognition in Infants with Cerebral Palsy or Motor Impairment: A Systematic Review","volume":"44","author":"Morgan","year":"2019","journal-title":"J. Pediatr. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.dcn.2016.11.001","article-title":"Beyond eye gaze: What else can eyetracking reveal about cognition and cognitive development?","volume":"25","author":"Eckstein","year":"2017","journal-title":"Dev. Cogn. Neurosci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3109\/17518423.2015.1132281","article-title":"Gaze-based assistive technology in daily activities by children with severe physical impairments\u2014An intervention study","volume":"20","author":"Borgestig","year":"2017","journal-title":"Dev. Neurorehabilit."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1080\/17518423.2017.1362057","article-title":"Eye-gaze control technology for children, adolescents and adults with cerebral palsy with significant physical disability: Findings from a systematic review","volume":"21","author":"Karlsson","year":"2018","journal-title":"Dev. Neurorehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2553","DOI":"10.1097\/00001756-200411150-00025","article-title":"Eye gaze cueing facilitates neural processing of objects in 4-month-old infants","volume":"15","author":"Reid","year":"2004","journal-title":"Neuroreport"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"\u00c7etin\u00e7elik, M., Rowland, C.F., and Snijders, T.M. (2021). Do the Eyes Have It? A Systematic Review on the Role of Eye Gaze in Infant Language Development. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.589096"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/infa.12225","article-title":"Limits on Composition of Conceptual Operations in 9-Month-Olds","volume":"23","author":"Piantadosi","year":"2018","journal-title":"Infancy"},{"key":"ref_15","unstructured":"Holmqvist, K., Nystr\u00f6m, M., Andersson, R., Dewhurst, R., Jarodzka, H., and Van de Weijer, J. (2011). Eye Tracking: A Comprehensive Guide to Methods and Measures, Oxford University Press."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1080\/17549507.2024.2425012","article-title":"Let the eyes do the talking: A scoping review of eye-tracking in paediatric communication assessment and intervention","volume":"27","author":"Hoopmann","year":"2024","journal-title":"Int. J. Speech. Lang. Pathol."},{"key":"ref_17","unstructured":"DCD Australia (2025, October 23). Diagnosis & Therapy. Available online: https:\/\/dcdaustralia.org.au\/diagnosis-therapy\/."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sadowska, M., Sarecka-Hujar, B., and Kopyta, I. (2021). Analysis of Selected Risk Factors Depending on the Type of Cerebral Palsy. Brain Sci., 11.","DOI":"10.3390\/brainsci11111448"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1080\/10349120903306533","article-title":"Perinatal Risk Factors for Mild Motor Disability","volume":"56","author":"Hands","year":"2009","journal-title":"Int. J. Disabil. Dev. Educ."},{"key":"ref_20","unstructured":"(2025, July 21). OCEBM Levels of Evidence\u2014Centre for Evidence-Based Medicine (CEBM), University of Oxford. Available online: https:\/\/www.cebm.ox.ac.uk\/resources\/levels-of-evidence\/ocebm-levels-of-evidence."},{"key":"ref_21","unstructured":"Kmet, L.M., Cook, L.S., and Lee, R.C. (2004). Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields, Alberta Heritage Foundation for Medical Research."},{"key":"ref_22","first-page":"1082","article-title":"The Benefits of Gaze-Based Assistive Technology in Daily Activities for Children with Disabilities","volume":"Volume 242","author":"Borgestig","year":"2017","journal-title":"Harnessing the Power of Technology to Improve Lives; Studies in Health Technology and Informatics"},{"key":"ref_23","first-page":"1109","article-title":"Gaze-Based Assistive Technology for a Toddler with Tetraplegia and Without Speech","volume":"Volume 242","author":"Hemmingsson","year":"2017","journal-title":"Harnessing the Power of Technology to Improve Lives; Studies in Health Technology and Informatics"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Hemmingsson, H., Ahlsten, G., Wandin, H., Rytterstr\u00f6m, P., and Borgestig, M. (2018). Eye-Gaze Control Technology as Early Intervention for a Non-Verbal Young Child with High Spinal Cord Injury: A Case Report. Technologies, 6.","DOI":"10.3390\/technologies6010012"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1038\/s41390-024-03239-8","article-title":"Exposure to the parents\u2019 speech is positively associated with preterm infant\u2019s face preference","volume":"96","author":"Aija","year":"2024","journal-title":"Pediatr. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/10400435.2015.1092182","article-title":"Eye gaze performance for children with severe physical impairments using gaze-based assistive technology\u2014A longitudinal study","volume":"28","author":"Borgestig","year":"2016","journal-title":"Assist Technol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.infbeh.2018.01.002","article-title":"Visual attention control differences in 12-month-old preterm infants","volume":"50","author":"Downes","year":"2018","journal-title":"Infant Behav. Dev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1093\/ptj\/pzz031","article-title":"Embodied Cognition in Practice: Exploring Effects of a Motor-Based Problem-Solving Intervention","volume":"99","author":"Harbourne","year":"2019","journal-title":"Phys. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"110397","DOI":"10.1016\/j.yebeh.2025.110397","article-title":"Gaze behavior in infancy associates with developmental outcome at the age of two years in early-onset epilepsies","volume":"167","author":"Jonsson","year":"2025","journal-title":"Epilepsy Behav."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101439","DOI":"10.1016\/j.infbeh.2020.101439","article-title":"Effects of motion and audio-visual redundancy on upright and inverted face and feature preferences in 4\u201313-month old pre- and full-term NICU graduates","volume":"60","author":"Kittler","year":"2020","journal-title":"Infant Behav. Dev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.earlhumdev.2019.01.015","article-title":"Perinatal risk factors for visuospatial attention and processing dysfunctions at 1 year of age in children born between 26 and 32 weeks","volume":"130","author":"Kooiker","year":"2019","journal-title":"Early Hum. Dev."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kooiker, M.J.G., van Gils, M.M., wafd der Zee, Y.J., Swarte, R.M.C., Smit, L.S., Loudon, S., van der Steen, S., Reiss, I.K.M., Pel, J.J.M., and van der Steen, J. (2021). Early Screening of Visual Processing Dysfunctions in Children Born Very or Extremely Preterm. Front. Hum. Neurosci., 15.","DOI":"10.3389\/fnhum.2021.729080"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1590\/2237-6089-2018-0083","article-title":"Visual scanning preferences in low birth weight preterm infants | Prefer\u00eancias de rastreamento visual em prematuros nascidos com baixo peso","volume":"41","author":"Lederman","year":"2019","journal-title":"Trends Psychiatry Psychother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1111\/apa.16647","article-title":"Language environment and parent-infant close contact in neonatal care and emerging lexical abilities of very preterm children\u2014A longitudinal study","volume":"112","author":"Latva","year":"2023","journal-title":"Acta Paediatr. Int. J. Paediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"105603","DOI":"10.1016\/j.earlhumdev.2022.105603","article-title":"Eye tracking based assessment of lexical processing and early lexical development in very preterm children","volume":"170","author":"Latva","year":"2022","journal-title":"Early Hum. Dev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"106191","DOI":"10.1016\/j.earlhumdev.2025.106191","article-title":"Developmental trajectories of visual orienting functions in children born very or extremely preterm","volume":"201","author":"Bijlsma","year":"2025","journal-title":"Early Hum. Dev."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Wagner, J.B.B., Jab\u00e8s, A., Norwood, A., and Nelson, C.A.A. (2020). Attentional measures of memory in typically developing and hypoxic\u2013ischemic injured infants. Brain Sci., 10.","DOI":"10.3390\/brainsci10110823"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/j.1532-7078.2011.00097.x","article-title":"Infant eyes: A window on cognitive development","volume":"17","author":"Aslin","year":"2012","journal-title":"Infancy"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/15248371003699977","article-title":"Using Habituation of Looking Time to Assess Mental Processes in Infancy","volume":"11","author":"Oakes","year":"2010","journal-title":"J. Cogn. Dev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1111\/cdev.13026","article-title":"Gaze Following Is Not Dependent on Ostensive Cues: A Critical Test of Natural Pedagogy","volume":"89","author":"Astor","year":"2018","journal-title":"CHILD Dev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1146\/annurev.psych.52.1.337","article-title":"The development of visual attention in infancy","volume":"52","author":"Colombo","year":"2001","journal-title":"Annu. Rev. Psychol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"109","DOI":"10.3233\/NRE-230149","article-title":"Music, occupational, physical, and speech therapy interventions for patients in disorders of consciousness: An umbrella review","volume":"54","author":"Murtaugh","year":"2024","journal-title":"NeuroRehabilitation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e70031","DOI":"10.1111\/infa.70031","article-title":"Automated Infant Eye Tracking: A Systematic Historical Review","volume":"30","author":"Ziavras","year":"2025","journal-title":"Infancy"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1011\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:17:32Z","timestamp":1785557852000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":44,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13081011"],"URL":"https:\/\/doi.org\/10.3390\/children13081011","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]}}}