Eye gaze measures could be important for improving medication trials for Fragile X Syndrome.

We all feel a little bit anxious when we meet new people for the first time. However, for individuals with fragile X, meeting new people can be a significant challenge associated with significant anxiety. Common signs of social anxiety include a pounding heart and avoidance of eye contact, which for individuals with fragile X may lead to missed social learning opportunities and potential social isolation.

In our recent study published in the American Journal of Medical Genetics, we invited boys and girls with fragile X to have a conversation with one of our research staff at Stanford in order to measure social anxiety symptoms, and in particular, the patterns of eye gaze avoidance that some children might show. Participants sat across a table from a member of the research team they hadn’t met before and engaged in a conversation for a 10-minute period. During the conversation, we used a state-of-the-art eye tracker to measure how often, how long, and where the children looked. We compared these metrics to children who had similar IQs and autistic symptoms but who did not have fragile X.

Interestingly, we found that children with fragile X had specific looking patterns that were different from the control children. For example, children with fragile X were less likely to look at the eyes, nose and mouth of the research staff member than control children. Furthermore, when children with fragile X looked at the research staff member, it was for much briefer time periods (1.5 seconds on average) than the control children.

Given that the looking patterns were so much different, even when compared to children with similar IQ levels, we believe that eye tracking measures should be employed in future clinical trials, in order to determine whether medications are working or not. At the present time, there are few valid and reliable measures which can be used to see whether the medications have made a difference. Most of the measures used are broad and general questionnaires which may not detect changes and do not necessarily focus upon the most prominent issues for people with fragile X. Therefore, a measure like eye tracking that measures meaningful differences during real-life social interactions could be beneficial to future efforts to find medications that are effective for helping people with fragile X.

Link to the study: http://onlinelibrary.wiley.com/doi/10.1002/ajmg.b.32331/abstract

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