# Eye Tracking for Rehabilitation and Training in Paediatric Neurodevelopmental Disorders: A Systematic Review

## TL;DR

Eye-tracking technology helps improve attention and cognitive skills in children with neurodevelopmental disorders by engaging their gaze and brain functions.

## Contribution

This systematic review highlights the novel use of gaze-contingent eye-tracking interventions to modulate neurocognitive functions across multiple pediatric disorders.

## Key findings

- Eye-tracking systems improve attention, inhibitory control, and social orienting in children with neurodevelopmental disorders.
- Gaze-contingent interventions modulate core functions like attentional control and visuomotor integration across diagnostic categories.
- Eye-tracking promotes personalized rehabilitation with high engagement and user satisfaction in pediatric populations.

## Abstract

What are the main findings?
Gaze-contingent eye-tracking interventions leverage the coupling between oculomotor control and fronto-striatal executive networks, producing improvements in attention, inhibitory control, social orienting, and visual processing in paediatric neurodevelopmental disorders.Eye-tracking systems modulate core neurocognitive functions (e.g., attentional control, joint attention, visuomotor integration) that cut across diagnostic categories.

Gaze-contingent eye-tracking interventions leverage the coupling between oculomotor control and fronto-striatal executive networks, producing improvements in attention, inhibitory control, social orienting, and visual processing in paediatric neurodevelopmental disorders.

Eye-tracking systems modulate core neurocognitive functions (e.g., attentional control, joint attention, visuomotor integration) that cut across diagnostic categories.

What are the implications of the main findings?
Targeting oculomotor–executive integration during developmental windows of heightened neural plasticity may enhance rehabilitation efficacy and early intervention strategies.Methodologically robust studies with standardised protocols and longitudinal designs are essential to clarify neural mechanisms and long-term transfer effects.

Targeting oculomotor–executive integration during developmental windows of heightened neural plasticity may enhance rehabilitation efficacy and early intervention strategies.

Methodologically robust studies with standardised protocols and longitudinal designs are essential to clarify neural mechanisms and long-term transfer effects.

Background: Eye-tracking (ET) devices are gaining attention in technology-based paediatric rehabilitation through their intrinsic ability to assess patients’ engagement and visual attention within motivating, technology-based environments. We conducted a systematic review of available evidence from 2004 to 2025 on the implementation of ET in rehabilitative trainings targeting paediatric populations with neurological and neurodevelopmental disorders. This paper aims to outline the rehabilitative outcomes pursued in the clinical populations considered. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were consulted to summarise the state of the art of the last 20 years. Selected articles were categorised according to the type of treated disorder and the rehabilitated function. Results: ET devices have been increasingly integrated into paediatric rehabilitation with promising results across multiple neurodevelopmental conditions (e.g., ASD, ADHD, cerebral palsy). These systems have proven effective not only in training gaze control, but also in enhancing executive functions, social cognition, communication, and participation. Furthermore, they promote personalised and data-driven solutions and support high levels of engagement, feasibility, and user satisfaction. Conclusions: ET represents a promising frontier for paediatric rehabilitation, addressing various neurodevelopmental disorders. The gaze-contingent protocols employed have demonstrated potential effects in promoting adaptive behaviour across multiple developmental areas. Further research is warranted to provide shared guidance and to strengthen practice recommendations.