Insights from Eye-Tracking Technology in Infants with or at Risk of a Motor Disability: A Systematic Review.

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 1-123), including 341 boys, 306 girls, and 20 infant genders unreported (M = 10.8 months; SD = 4.8; range 4-24 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.