February 19, 2025, 4:08 pm | Read time: 5 minutes
Early diagnosis of autism is crucial in order to provide affected children with the right support and encouragement. However, differentiating between autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) poses major challenges for professionals. Scientists are, however, on the trail of a solution: a newly developed video game can easily identify autism-specific characteristics in just one minute.
Traditionally, autism has been seen more as a social communication disorder, but motor abnormalities — especially problems with imitating movements — also play a role. And they could even be (partly) responsible for the deficits in communication, as body language is also affected. The motor peculiarities may also distinguish autism from frequently occurring concomitant disorders such as ADHD. A team of researchers from the Kennedy Krieger Institute and Nottingham Trent University has now investigated whether a movement test in the form of a video game can distinguish autism from ADHD and neurotypical development. The results are promising. The tool identified children with autism with 80 percent accuracy and could be a cost-effective and quick alternative to time-consuming diagnostic procedures.1
Table of Contents
The Researchers Wanted to Simplify the Diagnosis of Autism
The diagnosis of autism is often difficult, especially because symptoms can overlap with other neurodevelopmental disorders such as ADHD. Around 50 to 70 percent of children with autism also show symptoms of ADHD, which makes it difficult to differentiate between the two disorders. Dr. Stewart Mostofsky, co-author of the study, explains in a press release: “If the disorder is misdiagnosed, this can have an impact on the support and resources available to the child.”2 And therein lies the problem: to date, there are no simple and reliable markers to clearly distinguish autism from ADHD or neurotypical development.
However, the analysis of motor imitation could be a promising possibility. Studies show that children with autism have characteristic difficulties in imitating movements that differ from ADHD-associated motor abnormalities. This is where CAMI comes in: A video-based test that assesses a child’s ability to imitate in just one minute.
In the study, the scientists tested whether CAMI can identify autism and differentiate it from neurotypical children and those with ADHD.
Video Game Put to the Test in Cross-Sectional Analysis
The study was conducted as a cross-sectional analysis with 183 children aged between seven and 13 years. The participants were divided into four groups:
- Children with ADHD (35 subjects)
- Children with ASD and concurrent ADHD (63 subjects)
- Children with ASD (20 participants)
- Neurotypical children (65 test subjects)
The motor imitation ability was tested with CAMI. The children were asked to imitate the movements of an avatar in a video game while two cameras recorded their movements. Dr. Bahar Tunçgenç, the lead author, expresses enthusiasm: “What makes CAMI so exciting is its simplicity. Video games are fun for children, fast for clinicians, and provide clear results.”
After the children had imitated movements for one minute, CAMI calculated an imitation score between 0 (no imitation) and 1 (perfect imitation). In addition, standardized clinical tests were conducted to assess autism and ADHD symptoms as well as motor skills.
Statistical analyses, including regression models, receiver operating characteristic (ROC) curves, and machine learning methods (support vector machine, SVM), were used to evaluate the accuracy of the CAMI test.
Video Game Had High Accuracy in Identifying Autism
The results show that CAMI can identify autism with high accuracy. Children with ASD achieved significantly lower imitation scores than neurotypical children. Children with ADHD, on the other hand, did not differ significantly from neurotypical children in their imitation performance. In addition, the video game was able to distinguish autism from neurotypical development with an accuracy of 80 percent. What’s more, CAMI was even able to differentiate between autism and ADHD with a 70 percent accuracy rate. Within the ASD group, low CAMI scores were associated with more severe autism symptoms, particularly social deficits and repetitive behavior.
These results suggest that imitation deficits are a specific feature of autism and cannot be explained by motor or attention problems of ADHD.
What Is the Significance of the Results?
The study provides promising evidence that CAMI offers a quick, easy, and inexpensive way to diagnose autism and distinguish it from ADHD. Until now, diagnoses have been time-consuming, require trained professionals, and can result in long waiting times. CAMI could speed up this process and help affected children gain access to appropriate therapies sooner.
It is particularly relevant that CAMI recognizes autism-specific imitation deficits that are independent of other motor or attention-related problems. This could help to reduce misdiagnosis and enable more targeted support measures. In the future, CAMI could also be further developed for younger children or more severely affected individuals.
Dr. Mostofsky is positive about further developments: “This tool could change autism diagnosis worldwide. By identifying autism as accurately as possible, we can guide children towards interventions that will improve their quality of life and long-term prospects. We want CAMI to be widely used in clinics to support diagnosis.”
Classification of the Study
Although the results are promising, there are some limitations. Firstly, the sample size of the ASD group is relatively small, at 20 children, which could limit the statistical significance. Secondly, only children with an IQ above 70 were included, so it remains unclear how accurate CAMI would be in children with intellectual disabilities. Another issue is the long-term stability of the test results. It remains to be clarified whether CAMI reliably measures imitation performance across different age groups and whether the procedure can also be used with younger children.
Despite these limitations, the study shows that CAMI could be a promising addition to clinical diagnostics. Further studies with larger samples and in different age groups should be conducted in the future to validate the results and expand the field of application.
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Conclusion
The cross-sectional analysis shows that CAMI can reliably and quickly detect autism. In addition, the video game is able to differentiate between neurotypical development and ADHD with a high degree of accuracy, which shows that imitation deficits are a specific feature of autism. With its simple application and rapid implementation, CAMI could revolutionize diagnostics and help affected children receive the support they need earlier.