Seeing Attention. Measuring Restlessness. Improving Diagnostic Clarity.

ADHD has always been a condition we observe, infer, and interpret. For decades, clinicians have relied on interviews, behaviour reports, and rating scales to understand inattention, impulsivity, and hyperactivity. These remain essential—but they are also limited. Attention drifts silently. Restlessness is often suppressed. Compensation hides impairment.

Modern technology now allows us to see attention and measure movement in real time. Eye tracking and motion tracking are not replacements for clinical judgment, but they offer something psychiatry has long needed: objective behavioural markers that operate below conscious control.

Why Subjective Observation Isn’t Always Enough

Many individuals with ADHD—especially adults and high-functioning children—learn to mask symptoms. They sit still in the clinic. They answer questions carefully. Teachers and parents may disagree. Anxiety, sleep deprivation, and burnout further blur the picture.

This is why diagnostic agreement in ADHD, when based purely on interview and rating scales, remains only moderate. The question is not whether clinicians are skilled—it is whether the tools we use capture what actually happens when attention is challenged.

Eye tracking and motion tracking address this gap.

Eye Tracking: Watching Attention Drift

Eye movements are tightly linked to attention. Where the eyes go, attention usually follows. Maintaining steady fixation, suppressing irrelevant gaze shifts, and resisting impulsive eye movements all require intact executive control—precisely the functions affected in ADHD.

What Eye Tracking Measures

Eye-tracking technology captures:

• fixation stability (how long the eyes stay focused),

• saccades (rapid, impulsive eye movements),

• gaze variability (how often attention wanders),

• inhibitory control during tasks that require looking away from distractions.

These are micro-level processes that occur automatically, without conscious effort.

What Studies Show

Research consistently demonstrates that individuals with ADHD show:

• more frequent gaze shifts,

• reduced fixation duration,

• difficulty suppressing reflexive eye movements,

• increased variability during sustained attention tasks.

When eye-tracking data is combined with attention tasks, studies report classification accuracies in the range of 70–85%. Importantly, these findings correlate strongly with real-world inattentive and impulsive symptoms.

Eye tracking answers a simple but powerful question:
Does attention fail at the level of perception itself?

Motion Tracking: Measuring Restlessness, Not Guessing It

Hyperactivity is often misunderstood. In adults, it may appear as internal restlessness rather than overt fidgeting. In children, it may be suppressed in structured settings like clinics.

Motion tracking removes guesswork.

What Motion Tracking Measures

Using sensors or camera-based systems, motion tracking quantifies:

• frequency of movement,

• amplitude and variability of motion,

• ability to suppress movement during cognitive tasks.

Instead of describing someone as “restless,” we can now measure how much they move—and when.

What Research Shows

Studies using actigraphy and motion sensors demonstrate that individuals with ADHD:

• move more frequently during attention-demanding tasks,

• show greater variability in motor activity,

• struggle to inhibit movement even when motivated to do so.

When motion tracking is combined with cognitive tasks such as Continuous Performance Tests (CPTs), diagnostic accuracy improves substantially—often reaching 75–90% in experimental models.

Motion tracking is particularly useful in:

• children who “sit still” during interviews,

• adults with subjective inner restlessness,

• cases where anxiety and ADHD appear similar on history alone.

Why Eye Tracking and Motion Tracking Work So Well Together

Eye tracking captures where attention goes.
Motion tracking captures how the body responds.

ADHD is not just a disorder of attention or movement—it is a disorder of regulation. These two tools reflect different sides of the same problem.

Used together, they reveal a behavioural signature that is difficult to fake, suppress, or overinterpret.

Not Standalone Tests—Powerful Diagnostic Aids

It is important to be clear: eye tracking and motion tracking do not “diagnose” ADHD by themselves. No single test can. Their value lies in supporting clinical judgment, especially when combined with:

• a detailed clinical interview,

• CPTs,

• and, where appropriate, QEEG.

When findings converge, diagnostic confidence increases. When they don’t, clinicians are prompted to pause and reconsider—often uncovering alternative explanations such as anxiety, sleep disorders, or mood issues.

That is good medicine.

What This Means for Patients and Families

For patients, this approach reduces:

• prolonged diagnostic uncertainty,

• repeated opinions,

• unnecessary medication trials,

• and years of self-doubt.

For clinicians, it means:

• fewer false positives,

• fewer missed diagnoses,

• clearer treatment planning,

• and greater confidence in decision-making.

Objectivity does not replace empathy. It strengthens it.

The Future of ADHD Assessment

Psychiatry is slowly moving from opinion-heavy diagnosis toward evidence-weighted clinical judgment. Eye tracking and motion tracking are part of this shift—not as flashy gadgets, but as quiet tools that reveal what interviews alone cannot.

They help us see attention drift.
They help us measure restlessness.
They help us get closer to the truth.

About the Author

Dr. Srinivas Rajkumar T, MD (AIIMS), DNB, MBA (BITS Pilani)
Consultant Psychiatrist & Neurofeedback Specialist
Mind & Memory Clinic, Apollo Clinic Velachery (Opp. Phoenix Mall), Chennai

Dr. Srinivas Rajkumar T specialises in ADHD across the lifespan, neuropsychiatry, and objective diagnostic approaches. His clinical work integrates detailed clinical evaluation with behavioural, neurophysiological, and sensor-based tools to improve diagnostic accuracy and guide personalised care.

✉ srinivasaiims@gmail.com
📞 +91-8595155808