Research by Dr. Rebecca McNally Keehn (Indiana University) and Dr. Brandon Keehn (Purdue University), article by Luke Lekishon.
The early years of a child’s life are very important for their health and development. Healthy development means that children grow up where their social, emotional, and educational needs are met. Infants grow and soon they learn how to talk, sing and play as they interact with their caregivers. There are some children however, that take longer to develop than others. In some instances, this developmental delay is associated with a developmental difference called autism. Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition characterized by challenges in social interaction, communication, restricted interests, and repetitive behaviors. Autism affects individuals of all races, ethnicities, socioeconomic statuses and geographic regions. On the other hand, children with autism have been noted to have strengths in other areas such as visual processing. According to studies, autism affects more boys than girls and no one cause has been identified. Instead, autism is considered to result from a combination of both genetic and environmental factors. Due to this, parents (especially mothers) should not blame themselves for giving birth to autistic children.
With a steady rise in cases, there has come the need to accurately and efficiently diagnose the condition. Typically, autism diagnosis is done by developmental-behavioral pediatricians, child neurologists, child psychologists, and child psychiatrists. But with such expertise in short supply, there has been an urgent need to make diagnosis more efficient. The Autism Diagnostic Observation Schedule - 2 (ADOS-2), an observational assessment tool, was created to standardize observation across different children, clinicians, and locations. It helps a clinician to construct a profile of strengths and difficulties for intervention planning. The ADOS-2 involves using specific materials to create a social environment in which social-communication impairments and restricted and repetitive behaviors associated with autism can be observed. Once the observations have been made, the behaviors are coded (scored) and an algorithm is used to determine the diagnostic classification. While it is not recommended that the ADOS-2 be used on its own to make a diagnosis, a trained clinician can use it to determine the possibility of autism and begin interventions as the child (or client) awaits an official diagnosis from a developmental-behavioral pediatrician.
The ADOS-2 can only be used in cases where there are no significant sensory impairments (e.g. blindness, deafness) or motor impairments. It takes 40 to 60 minutes to administer but additional time is needed for coding. It has five modules (categories) that cater for the different developmental levels of the subjects. These range from Module T for toddlers who have no speech or use simple phrases (usually 12 to 30 months old), to Module 2 for those children who use three-word phrases (not yet verbally fluent), to Module 4 which is for older adolescents or adults (who are verbally fluent). The activities in each module differ, from response to name, free play, and bubble play (playing with bubbles) for toddlers and younger kids, to demonstration tasks, conversation and reporting, and emotional challenges for adolescents and adults. Ultimately, the ADOS-2 provides a means of standardizing direct observation to promote consistency of diagnosis.
Eye-tracking is a new technology which is used to understand brain and behavior function by measuring eye movements and pupil size. Despite still being in the research phase, tests have shown that eye tracking can be used to detect the presence of autism with significant accuracy. The basic idea in eye tracking is to point a camera at the eye and use image processing to determine the position of salient features, namely: the pupil and corneal reflection. Images are then displayed on a screen and eye movements and changes in pupil size are measured to a high degree of accuracy. In autistic cases, subjects are noted to fixate on certain areas of the screen more than others. When shown pictures of social interaction (children playing) versus non-social images (shapes and patterns), it was noted that autistic children spend more time focusing on the latter. Since eye tracking focuses primarily on the eyes, the technology can be used on very young children who have not even developed speech. Due to this, diagnosis can be made early and interventions can begin before the condition progresses.
In February 2026, a workshop was held at the Kenya Institute of Special Education (KISE) to create awareness on the ADOS-2 and eye tracking. Dr. Rebecca McNally Keehn (Indiana University) and Dr. Brandon Keehn (Purdue University) made presentations on how these technologies can be used to aid in autism diagnosis in Kenya. The workshop was attended by professionals from all over the country and served as a starting point to mainstream the use of these technologies in local communities in Kenya. Data collected from both the United States and Kenya was presented to demonstrate the effectiveness of these tools in different settings.
In conclusion, both the ADOS-2 and eye tracking are proving to be powerful tools in the sphere of autism diagnosis. However, a major drawback is the cost implication that comes with their use. The ADOS-2 kit is very costly and the process of training examiners to use it may also prove to be daunting. Currently, the eye tracking system is also expensive although an affordable version that does not require extensive training is now being developed. In the future, the goal is that inexpensive, scalable approaches to autism diagnosis will be available in local Kenyan communities to address the growing need for autism assessment services.
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