Abstract
Exploring early-stage orienting behavior is essential for elucidating the behavioral mechanisms underlying attentional shifts in attention deficit hyperactivity disorder (ADHD). However, traditional tasks lacking eye-tracking data often obscure these mechanisms. This study investigates low-level attentional shifting in ADHD using a simplified gaze-cueing task and explores classification markers via eye movement. Eye-tracking data were analyzed from 27 typically developing children and 19 children diagnosed with ADHD. We constructed a logistic regression model for classification purposes. Eye movement data alone yielded an accuracy of 0.84, comparable to the accuracy achieved using combined eye-tracking and behavioral data (0.87), underscoring the sensitivity of gaze-based features. Children with ADHD exhibited significantly prolonged inter-saccadic fixations in non-target regions (p = .02, d = 0.80) and marginally reduced saccade frequency (p = .06, d = − 0.52) during target detection, indicating delayed attentional shifting and diminished goal-directed attention. Prolonged fixation during target detection behavior emerged as the strongest predictor, correlating with both inattention and hyperactivity (r = .46; r = .36; both p < .01). Additionally, children with ADHD demonstrated lower response to joint attention and a greater reliance on peripheral vision. These findings highlight distinct gaze patterns under low cognitive load, revealing subtle mechanisms of executive dysfunction and potential early classification markers.
Data availability
The datasets generated and/or analyzed during this study are not publicly available due to participant confidentiality agreements, but are available from the corresponding author on reasonable request.
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Funding
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2020M3E5D9080787). This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant Number: HI22C0646). This study was supported by the U-K (UNIST-Korea) research brand program (1.230016.01) funded by UNIST (Ulsan National Institute of Science & Technology).
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L.S.M. conceived the study, collected data, performed preprocessing and statistical analyses, and wrote the original draft. L.S.I. contributed to the conceptualization, experimental design, discussion, and revision of the manuscript. J.I.J. collected data and contributed to the original draft. J.J.H. collected data and contributed to data preprocessing and statistical analyses. P.H.J. contributed to the conceptualization. K.M.K. contributed to the conceptualization, provided advice on data analysis, revised the manuscript, and acquired funding. Z.T. contributed to the discussion and revision of the manuscript. S.S. contributed to the conceptualization and funding acquisition. J.D.Y. contributed to the conceptualization and methodology, revised the manuscript, supervised the project, and acquired funding. All authors reviewed and approved the final manuscript.
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This study was approved by the Central Research Facilities Research Ethics Board of the Ulsan National Institute of Science and Technology (UNISTIRB-20-62-A).
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Lee, S., Lee, S., Jeong, I. et al. Exploring early-stage orienting behavior using an eye tracker for attention deficit hyperactivity disorder classification. Sci Rep (2026). https://doi.org/10.1038/s41598-026-41419-0
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DOI: https://doi.org/10.1038/s41598-026-41419-0
