Accepted for/Published in: JMIR Serious Games
Date Submitted: May 7, 2025
Date Accepted: Aug 28, 2025
Gamification effect on task engagement during an eye-tracking test battery in five-year-old preterm born children: observational study
ABSTRACT
Background:
Maintaining engagement during eye-tracking assessments with young children is challenging, often resulting in significant data loss due to distractions. This leads to acquiring repeated measurements, which can be taxing for young children and cause imprecise measurements.
Objective:
This study compares a standard eye-tracking test battery of our design with a gamified cartoon version to evaluate the effectiveness of gamification in reducing data loss. The gamified test incorporated child-friendly visuals with the objective of creating context for the stimuli presented. Data quality was assessed by quantifying the percentage of unusable gaze data and task completion rates with an approach we have called lost data index (LDI).
Methods:
We demonstrate our results in a cohort of 25 preterm five-year-old children with two objectives (1) directly comparing the LDI for the two versions of the test and (2) investigate if, in case of employing a dynamic stopping criterion to both tests, the higher data quality of the gamified procedure allows to stop the test earlier. The stopping criterion chosen is based on having a certain number of tasks with an LDI value below a certain threshold.
Results:
The gamified version demonstrated a significant reduction in data loss compared to the standard version in the first (p<0.001) and second (p=0.009) quarter of the test. In addition to a higher rate of admissible tasks, concentrated at the beginning of the tests, allow the cartoon test to be stopped after a smaller number of tasks. This, in conjunction with the longer tasks of the cartoon test, results in comparable test lengths uniformly for all thresholds measured by Area under the Curve (p=0.21).
Conclusions:
These findings highlight the potential of serious games in eye-tracking cognitive assessments for 5-year-old premature children. Specifically, gamification might allow for higher retention rates and more effective tests, possibly without an increase in duration of testing procedures.
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