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DeLucia EA, McFayden TC, Fok M, Andrzejewski TM, Scarpa A, McDonnell CG. Frequency and correlates of augmentative and alternative communication use in an autistic inpatient sample. J Autism Dev Disord 2024; 54:2060-2068. [PMID: 35796911 DOI: 10.1007/s10803-022-05650-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
Although augmentative and alternative communication (AAC) strategies are often used by autistic youth, little is known about the use of AAC in inpatient psychiatric settings. This study evaluated how demographic and clinical factors (e.g., language level, IQ) related to AAC use in a well-characterized sample of 527 autistic youth (78.7% male, mean age 12.94) who participated in the Autism Inpatient Collection. AAC use was common, with 42.5% of caregivers reporting at least one form of AAC. White children were more likely to use AAC than non-white children at the bivariate level. In regression analyses, young children were more likely to use AAC than older children. These results suggest the importance of provider training and improved equitable access to AAC.
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Affiliation(s)
- Elizabeth A DeLucia
- Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, 24061, Blacksburg, VA, USA.
| | - Tyler C McFayden
- Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, 24061, Blacksburg, VA, USA
| | - Megan Fok
- Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, 24061, Blacksburg, VA, USA
| | | | - Angela Scarpa
- Department of Psychology, Virginia Polytechnic Institute & State University, Williams Hall, 24061, Blacksburg, VA, USA
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2
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Eigsti IM. The Autism Constellation and Neurodiversity: Long-Term and Adult Outcomes in Autism Spectrum Disorder. Pediatr Clin North Am 2024; 71:327-341. [PMID: 38423724 PMCID: PMC10914322 DOI: 10.1016/j.pcl.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Research on autistic adults suggests significant heterogeneity in outcomes. A significant proportion of individuals struggle with intellectual disability and limited communication skills. Of the 67% who have age-appropriate cognitive skills, around half are expected to attain a college education, and 25% are likely to hold a full-time job. Outcomes have been improving over time, in part because of earlier diagnosis and earlier intervention. Indeed, an estimated 10% to 20% are expected to lose all symptoms of autism by adolescence.
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Affiliation(s)
- Inge-Marie Eigsti
- Connecticut Autism and Language Lab (CALL), University of Connecticut; Cognitive Neuroscience of Communication T32 Training Program; Institute for the Brain and Cognitive Sciences; Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269, USA.
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3
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Xiong H, Liu X, Yang F, Yang T, Chen J, Chen J, Li T. Developmental Language Differences in Children with Autism Spectrum Disorders and Possible Sex Difference. J Autism Dev Disord 2024; 54:841-851. [PMID: 36538127 DOI: 10.1007/s10803-022-05806-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 12/24/2022]
Abstract
Developmental difference is a common characteristic of autism spectrum disorder (ASD) with unclear sex differences. The current study included 610 children with ASD, aged between 2 and 7 years, with completed language profiles. We used a nonparametric item response theory model called Mokken scale analysis to examine the order of acquisition of developmental language milestones in children with ASD. Our results demonstrated the developmental language differences in the expressive and receptive language dimensions in children with ASD compared with typical developmental sequences. Furthermore, The acquisition of gestures and pragmatics was more impaired in the female subgroup than in the male subgroup. The identified developmental language sequence could help provide a more comprehensive ASD developmental profile.
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Affiliation(s)
- Haiyi Xiong
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, No.136 Zhongshan Er Road, Yuzhong District, Chongqing, 400014, People's Republic of China
| | - Xiao Liu
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, No.136 Zhongshan Er Road, Yuzhong District, Chongqing, 400014, People's Republic of China
| | - Feng Yang
- Department of Language Disorders, Shenzhen Second People's Hospital, Shenzhen, China
| | - Ting Yang
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, No.136 Zhongshan Er Road, Yuzhong District, Chongqing, 400014, People's Republic of China
| | - Jinjin Chen
- Department of Child Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Chen
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, No.136 Zhongshan Er Road, Yuzhong District, Chongqing, 400014, People's Republic of China.
| | - Tingyu Li
- Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Childhood Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, No.136 Zhongshan Er Road, Yuzhong District, Chongqing, 400014, People's Republic of China.
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4
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Silkey M, Durán-Pacheco G, Johnson M, Liu C, Clinch S, Law K, Loss G. The Autism Impact Measure (AIM): Meaningful Change Thresholds and Core Symptom Changes Over One Year from an Online Survey in the U.S. J Autism Dev Disord 2023; 53:3422-3434. [PMID: 35788854 PMCID: PMC10465376 DOI: 10.1007/s10803-022-05635-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 10/17/2022]
Abstract
Validated outcome measures with the capacity to reflect meaningful change are key to assessing potential interventions for autism spectrum disorder (ASD). We derive clinically meaningful change thresholds (MCTs) of the Autism Impact Measure (AIM) and identify factors associated with meaningful change. Baseline and 12-months follow-up survey of caregivers of 2,761 children with ASD aged 3-17 years from the U.S. Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort were analyzed. Using caregiver-reported anchors for change, the 12-month change in estimated AIM MCT (95% confidence interval) for symptom improvement was -4.5 (-7.61, -1.37) points and 9.9 (5.12, 14.59) points for symptom deterioration. These anchor-based MCTs will facilitate future assessments of caregiver-reported change in AIM scores.
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Affiliation(s)
| | | | - Michelle Johnson
- Roche Products Ltd, Welwyn Garden City, UK.
- Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW, UK.
| | - Chuang Liu
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Kiely Law
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Georg Loss
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
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5
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Miniarikova E, Audras-Torrent L, Berard M, Peries M, Picot MC, Munir K, Baghdadli A. Adaptive behaviors and related factors in children and adolescents with autism spectrum disorder: Report from ELENA cohort. J Psychiatr Res 2023; 163:43-54. [PMID: 37201237 DOI: 10.1016/j.jpsychires.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/02/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
There are strong individual differences in adaptive behaviors (AB) in autism spectrum disorder (ASD) with conflicting results in literature about specific patterns and related factors. The present study aims to describe AB and identify related factors in terms of clinical and socio-familial characteristics in 875 children and adolescents with ASD in the multiregional ELENA cohort in France. Results showed that AB in children and adolescents with ASD were lower than in typically developing subjects, regardless of age group. AB were associated with clinical (gender, age at diagnosis, IQ, ASD severity, psychiatric comorbidities, motor and language skills, challenging behaviors), interventional (school attendance, special interventions) and familial characteristics (age, educational and socio-economic status of parents, household status, number of siblings). There is a need of interventions focusing on improvement of AB, tailored to children's characteristics.
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Affiliation(s)
- Ela Miniarikova
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France.
| | - Lee Audras-Torrent
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France.
| | - Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| | - Marianne Peries
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| | - Marie-Christine Picot
- Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France; Clinical Research and Epidemiology Unit, Department of Medical Information, University Hospital, CHU Montpellier, France.
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France; Faculté de Médecine, Université de Montpellier, France.
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6
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Yao PY, Iao LS, Wu CC. Language development trajectories in young children with developmental disabilities in Taiwan. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104470. [PMID: 36889171 DOI: 10.1016/j.ridd.2023.104470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/10/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Language development is critical to various outcomes in young children with developmental disabilities (DD), including autism spectrum disorder (ASD) and non-ASD delays. However, language development trajectories in young children with DD in non-Western populations remain unclear. AIMS To investigate the language development trajectories of young children with DD in Taiwan. We investigated the relationship between trajectory class assignment and diagnostic outcomes (ASD or non-ASD delays) at 3 years after enrollment in the study and the differences in early abilities among children in different trajectory classes. METHODS AND PROCEDURES The participants were 101 young children with DD (mean age: 21.88 months; follow-up: 1.5 and 3 years after enrollment). Growth mixture modeling analyses were conducted to receptive language developmental quotients (RLDQ) and expressive language developmental quotients (ELDQ) on the basis of the Mullen Scales of Early Learning. OUTCOMES AND RESULTS Three RLDQ trajectories were identified, namely age expected, delayed catch-up, and delayed, and two ELDQ trajectories were identified, namely delayed improve and delayed. Trajectory class assignment was related to diagnostic outcomes. Children who demonstrated more proficient skills at the early time point, demonstrated improved language outcomes 3 years later. However, adaptive functioning did not differ between the two ELDQ trajectory classes. CONCLUSIONS AND IMPLICATIONS Language development in young children with DD in Taiwan is heterogeneous. Delayed receptive and expressive language development trajectories relate to later ASD diagnoses.
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Affiliation(s)
- Pei-Yu Yao
- Department of Psychiatry, Kuang-Tien General Hospital, No. 117, Shatian Rd., Taichung, 433401, Taiwan
| | - Lai-Sang Iao
- Department of Psychology, Nottingham Trent University, 50 Shakespeare St., Nottingham NG1 4FQ, United Kingdom
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, No.100, Shin-Chuan 1st Rd., Kaohsiung, 807378, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd., Kaohsiung, 807378, Taiwan.
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7
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Shekarro M, Hassanzadeh S, Kellems R, Nikkhoo F. Identification of Autism spectrum disorder by parents: a retrospective-comparative study of the role of early behavioral signs, developmental and demographic characteristics. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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8
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Maksimović S, Marisavljević M, Stanojević N, Ćirović M, Punišić S, Adamović T, Đorđević J, Krgović I, Subotić M. Importance of Early Intervention in Reducing Autistic Symptoms and Speech-Language Deficits in Children with Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010122. [PMID: 36670672 PMCID: PMC9857540 DOI: 10.3390/children10010122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/05/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023]
Abstract
The intervention focused on starting treatment at an early age to develop the child’s full potential, which is known as early intervention. Given that autistic symptoms and language deficits occur at an early age and affect other areas of development in children with autistic spectrum disorder, we wanted to examine if early intervention is more effective in the reduction in autistic symptoms and language deficits in children aged 36−47 months old when compared to children 48−60 months old. The sample consisted of 29 children diagnosed with ASD who were admitted for integrative therapy. All participants were divided into two groups based on age: G1: 36−47 months old children, and G2: 48−60 months old children. To estimate the presence of autistic symptoms, we used the GARS-3, and for the assessment of speech−language abilities, we used the subscale Estimated Speech and Language Development (ESLD). Our results regarding the effect of the group on the difference in the scores at two time points showed that there was a statistically significant effect of the group on the reduction in autistic symptoms (p < 0.05) but no effect of the group on the differences in speech−language abilities between the two time points (p > 0.05). Our study highlights the importance of emphasizing the exact age when using the terms “early intervention” and “early development” in future studies and practice because it is necessary to determine and establish guidelines about which particular ages are crucial for starting treatment in certain developmental aspects.
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Affiliation(s)
- Slavica Maksimović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activitites Advancement Center”, 11000 Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology “Đorđe Kostić”, 11000 Belgrade, Serbia
| | - Maša Marisavljević
- Cognitive Neuroscience Department, Research and Development Institute “Life Activitites Advancement Center”, 11000 Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology “Đorđe Kostić”, 11000 Belgrade, Serbia
| | - Nina Stanojević
- Cognitive Neuroscience Department, Research and Development Institute “Life Activitites Advancement Center”, 11000 Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology “Đorđe Kostić”, 11000 Belgrade, Serbia
- Correspondence:
| | - Milica Ćirović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activitites Advancement Center”, 11000 Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology “Đorđe Kostić”, 11000 Belgrade, Serbia
| | - Silvana Punišić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activitites Advancement Center”, 11000 Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology “Đorđe Kostić”, 11000 Belgrade, Serbia
| | - Tatjana Adamović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activitites Advancement Center”, 11000 Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology “Đorđe Kostić”, 11000 Belgrade, Serbia
| | - Jelena Đorđević
- Clinic for Neurology and Psychiatry for Children and Youth, 11000 Belgrade, Serbia
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Ivan Krgović
- Institute for Children’s Diseases, Clinical Center of Montenegro, 81000 Podgorica, Montenegro
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activitites Advancement Center”, 11000 Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology “Đorđe Kostić”, 11000 Belgrade, Serbia
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9
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Naples A, Tenenbaum EJ, Jones RN, Righi G, Sheinkopf SJ, Eigsti IM. Exploring communicative competence in autistic children who are minimally verbal: The Low Verbal Investigatory Survey for Autism (LVIS). AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221136657. [PMID: 36373838 PMCID: PMC10183057 DOI: 10.1177/13623613221136657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Approximately one in three autistic children is unable to communicate with language; this state is often described as minimally verbal. Despite the tremendous clinical implications, we cannot predict whether a minimally verbal child is simply delayed (but will eventually develop spoken language) or will continue to struggle with verbal language, and might therefore benefit from learning an alternative form of communication. This is important for clinicians to know, to be able to choose the most helpful interventions, such as alternative forms of communication. In addition, the field lacks a standard definition of "minimally verbal." Even when we do agree on what the term means (e.g. fewer than 20 words), describing a child based on their lack of words does not tell us whether that child is communicating in other ways or how they are using those 20 words. To address these concerns, we developed the Low Verbal Investigatory Survey (LVIS), a one-page parent-report measure designed to help us characterize how minimally verbal autistic children are communicating. Parents of 147 children (aged 1-8 years) completed the LVIS. Here, we ask (1) whether the survey measures what it was designed to measure, that is, communicative ability in children without much spoken language, and (2) how the LVIS relates to cognitive and language ability, and symptoms of autism. Results suggest that this survey, which takes only 5 min to complete, is a good estimate of the child's communication skills. Furthermore, LVIS survey scores are correlated with other measures of language and cognitive abilities as well as autism symptomatology. The LVIS has the potential to save time and money in both clinical and research efforts to assess communication skills in minimally verbal autistic children.
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Affiliation(s)
| | - Elena J Tenenbaum
- Women & Infants Hospital, USA.,Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Duke University Medical Center, USA
| | | | - Giulia Righi
- Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Brown University, USA
| | - Stephen J Sheinkopf
- Women & Infants Hospital, USA.,Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Brown University, USA.,University of Missouri, USA
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10
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Buzhardt J, Wallisch A, Irvin D, Boyd B, Salley B, Jia F. Exploring Growth in Expressive Communication of Infants and Toddlers With Autism Spectrum Disorder. JOURNAL OF EARLY INTERVENTION 2022; 44:3-22. [PMID: 35400984 PMCID: PMC8993140 DOI: 10.1177/1053815121995578] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
One of the earliest indicators of autism spectrum disorder (ASD) is delay in language and social communication. Despite consensus on the benefits of earlier diagnosis and intervention, our understanding of the language growth of children with ASD during the first years of life remains limited. Therefore, this study compared communication growth patterns of infants and toddlers with ASD to growth benchmarks of a standardized language assessment. We conducted a retrospective analysis of growth on the Early Communication Indicator (ECI) of 23 infants and toddlers who received an ASD diagnosis in the future. At 42 months of age, children with ASD had significantly lower rates of gestures, single words, and multiple words, but significantly higher rates of nonword vocalizations. Children with ASD had significantly slower growth of single and multiple words, but their rate of vocalization growth was significantly greater than benchmark. Although more research is needed with larger samples, because the ECI was designed for practitioners to monitor children's response to intervention over time, these findings show promise for the ECI's use as a progress monitoring measure for young children with ASD. Limitations and the need for future research are discussed.
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Affiliation(s)
| | | | | | | | | | - Fan Jia
- University of California, Merced, USA
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11
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Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism. Lancet 2022; 399:271-334. [PMID: 34883054 DOI: 10.1016/s0140-6736(21)01541-5] [Citation(s) in RCA: 258] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Paul Carbone
- Department of Pediatrics at University of Utah, Salt Lake City, UT, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Themba Carr
- Rady Children's Hospital San Diego, Encinitas, CA, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | | | | | - Peter Mundy
- University of California, Davis, Davis, CA, USA
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Vicky Slonims
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul P Wang
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, NY, USA; Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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12
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Wickstrom J, Farmer C, Snyder LG, Mitz AR, Sanders SJ, Bishop S, Thurm A. Patterns of delay in early gross motor and expressive language milestone attainment in probands with genetic conditions versus idiopathic ASD from SFARI registries. J Child Psychol Psychiatry 2021; 62:1297-1307. [PMID: 34382689 PMCID: PMC9939014 DOI: 10.1111/jcpp.13492] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Recent large-scale initiatives have led to systematically collected phenotypic data for several rare genetic conditions implicated in autism spectrum disorder (ASD). The onset of developmentally expected skills (e.g. walking, talking) serve as readily quantifiable aspects of the behavioral phenotype. This study's aims were: (a) describe the distribution of ages of attainment of gross motor and expressive language milestones in several rare genetic conditions, and (b) characterize the likelihood of delays in these conditions compared with idiopathic ASD. METHODS Participants aged 3 years and older were drawn from two Simons Foundation Autism Research Initiative registries that employed consistent phenotyping protocols. Inclusion criteria were a confirmed genetic diagnosis of one of 16 genetic conditions (Simons Searchlight) or absence of known pathogenic genetic findings in individuals with ASD (SPARK). Parent-reported age of acquisition of three gross motor and two expressive language milestones was described and categorized as on-time or delayed, relative to normative expectations. RESULTS Developmental milestone profiles of probands with genetic conditions were marked by extensive delays (including nonattainment), with highest severity in single gene conditions and more delays than idiopathic ASD in motor skills. Compared with idiopathic ASD, the median odds of delay among the genetic groups were higher by 8.3 times (IQR 5.8-16.3) for sitting, 12.4 times (IQR 5.3-19.5) for crawling, 26.8 times (IQR 7.7-41.1) for walking, 2.7 times (IQR 1.7-5.5) for single words, and 5.7 times (IQR 2.7-18.3) for combined words. CONCLUSIONS Delays in developmental milestones, particularly in gross motor skills, are frequent and may be among the earliest indicators of differentially affected developmental processes in specific genetically defined conditions associated with ASD, as compared with those with clinical diagnoses of idiopathic ASD. The possibility of different developmental pathways leading to ASD-associated phenotypes should be considered when deciding how to employ specific genetic conditions as models for ASD.
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Affiliation(s)
- Jordan Wickstrom
- Neurodevelopmental and Behavioral Phenotyping Service, National Institutes of Health, Bethesda, MD, USA
| | - Cristan Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, National Institutes of Health, Bethesda, MD, USA
| | | | - Andrew R. Mitz
- Laboratory of Neuropsychology, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Stephan J. Sanders
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institutes of Health, Bethesda, MD, USA
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13
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Djerassi M, Ophir S, Atzil S. What Is Social about Autism? The Role of Allostasis-Driven Learning. Brain Sci 2021; 11:1269. [PMID: 34679334 PMCID: PMC8534207 DOI: 10.3390/brainsci11101269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 12/27/2022] Open
Abstract
Scientific research on neuro-cognitive mechanisms of autism often focuses on circuits that support social functioning. However, autism is a heterogeneous developmental variation in multiple domains, including social communication, but also language, cognition, and sensory-motor control. This suggests that the underlying mechanisms of autism share a domain-general foundation that impacts all of these processes. In this Perspective Review, we propose that autism is not a social deficit that results from an atypical "social brain". Instead, typical social development relies on learning. In social animals, infants depend on their caregivers for survival, which makes social information vitally salient. The infant must learn to socially interact in order to survive and develop, and the most prominent learning in early life is crafted by social interactions. Therefore, the most prominent outcome of a learning variation is atypical social development. To support the hypothesis that autism results from a variation in learning, we first review evidence from neuroscience and developmental science, demonstrating that typical social development depends on two domain-general processes that determine learning: (a) motivation, guided by allostatic regulation of the internal milieu; and (b) multi-modal associations, determined by the statistical regularities of the external milieu. These two processes are basic ingredients of typical development because they determine allostasis-driven learning of the social environment. We then review evidence showing that allostasis and learning are affected among individuals with autism, both neurally and behaviorally. We conclude by proposing a novel domain-general framework that emphasizes allostasis-driven learning as a key process underlying autism. Guided by allostasis, humans learn to become social, therefore, the atypical social profile seen in autism can reflect a domain-general variation in allostasis-driven learning. This domain-general view raises novel research questions in both basic and clinical research and points to targets for clinical intervention that can lower the age of diagnosis and improve the well-being of individuals with autism.
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Affiliation(s)
| | | | - Shir Atzil
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem 9190501, Israel; (M.D.); (S.O.)
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14
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The Impact of Birth Order on Language Development in Autistic Children from Simplex Families. J Autism Dev Disord 2021; 52:3861-3876. [PMID: 34498150 DOI: 10.1007/s10803-021-05274-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
The current study investigated the impact of birth order on vocabulary and social language development in 1338 first-born and 1049 s-born autistic youth (M age = 9.03 years, SD = 3.57; 86.4% male) from the Simons Simplex Collection. Frequentist and Bayesian analyses revealed mixed findings in language development. There were no differences in vocabulary or social language between first-born and second-born children. However, birth order and income together predicted expressive vocabulary and inappropriate speech such that birth order had a greater impact on language in lower-income families. This is the first study to investigate the impact of birth order on language outcomes in autistic youth and has implications for early intervention in lower-resourced communities.
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15
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Chaware SH, Dubey SG, Kakatkar V, Jankar A, Pustake S, Darekar A. The Systematic Review and Meta-analysis of Oral Sensory Challenges in Children and Adolescents with Autism Spectrum Disorder. J Int Soc Prev Community Dent 2021; 11:469-480. [PMID: 34760790 PMCID: PMC8533039 DOI: 10.4103/jispcd.jispcd_135_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The purpose of the systematic review was to provide a summary and evaluation of oral sensory challenges in children and adolescents with autism spectrum disorder (ASD). MATERIALS AND METHODS The review evaluated 19 studies that met the inclusion and search criteria. The review is registered in Prospero Database (CRD42020179852). The 14 studies (8 case-control, 4 cohort, 1 observational, and 1 randomized clinical trial) were related to speech disorders and five studies (case-control studies) were associated with feeding and eating behavior in ASD. The meta-analysis of speech and feeding behavior was analyzed by using risk ratios (RRs) and standardized mean difference (SMD), with 95% confidence interval (CI). RESULTS The meta-analysis found a statistically significant difference of speech disorder between children and adolescents of ASD when compared with typically developed or other neurotypical children of similar age [0.4891 (95% CI = -2.4580; 1.4799), fixed effect; -0.1726 (95% CI = -14.2925; 7.5697), random effect]. Feeding and eating behavior reported a statistically significant difference between ASD children and adolescents with similar age group of typically developed controls [0.0433 (95% CI = -0.3531; 0.4398), fixed-effect; 0.3711 (95% CI = -3.0751; 3.8172), random effect]. CONCLUSION The speech errors and feeding behavior were more consistent in ASD than in typically developed controls. The oral sensory challenges such as speech disorder and feeding behavior were more prevalent in ASD children and adolescents than in typically developed children and adolescents of the same age group. There was a significant lack in oral sensory-motor synchronization, incomplete motor planning, and poor oral neuromuscular coordination.
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Affiliation(s)
- Sachin Haribhau Chaware
- Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College, DMIMS, Swangi (M), Wardha, Maharashtra, India
| | - Surekha Godbole Dubey
- Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College, DMIMS, Swangi (M), Wardha, Maharashtra, India
| | - Vinay Kakatkar
- Department of Prosthodontics and Crown and Bridge, SMBT IDSR Dental College Dhamangaon, Nashik, Maharashtra, India
| | - Ajit Jankar
- Department of Prosthodontics and Crown and Bridge, MIDSR Dental College and Hospital, Latur, Maharashtra, India
| | - Swati Pustake
- Department of Prosthodontics and Crown and Bridge, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Abhishek Darekar
- Department of Prosthodontics and Crown and Bridge, MIDSR Dental College and Hospital, Latur, Maharashtra, India
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16
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Floris DL, Wolfers T, Zabihi M, Holz NE, Zwiers MP, Charman T, Tillmann J, Ecker C, Dell'Acqua F, Banaschewski T, Moessnang C, Baron-Cohen S, Holt R, Durston S, Loth E, Murphy DGM, Marquand A, Buitelaar JK, Beckmann CF. Atypical Brain Asymmetry in Autism-A Candidate for Clinically Meaningful Stratification. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:802-812. [PMID: 33097470 DOI: 10.1016/j.bpsc.2020.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Autism spectrum disorder ("autism") is a highly heterogeneous neurodevelopmental condition with few effective treatments for core and associated features. To make progress we need to both identify and validate neural markers that help to parse heterogeneity to tailor therapies to specific neurobiological profiles. Atypical hemispheric lateralization is a stable feature across studies in autism, but its potential as a neural stratification marker has not been widely examined. METHODS In order to dissect heterogeneity in lateralization in autism, we used the large EU-AIMS (European Autism Interventions-A Multicentre Study for Developing New Medications) Longitudinal European Autism Project dataset comprising 352 individuals with autism and 233 neurotypical control subjects as well as a replication dataset from ABIDE (Autism Brain Imaging Data Exchange) (513 individuals with autism, 691 neurotypical subjects) using a promising approach that moves beyond mean group comparisons. We derived gray matter voxelwise laterality values for each subject and modeled individual deviations from the normative pattern of brain laterality across age using normative modeling. RESULTS Individuals with autism had highly individualized patterns of both extreme right- and leftward deviations, particularly in language, motor, and visuospatial regions, associated with symptom severity. Language delay explained most variance in extreme rightward patterns, whereas core autism symptom severity explained most variance in extreme leftward patterns. Follow-up analyses showed that a stepwise pattern emerged, with individuals with autism with language delay showing more pronounced rightward deviations than individuals with autism without language delay. CONCLUSIONS Our analyses corroborate the need for novel (dimensional) approaches to delineate the heterogeneous neuroanatomy in autism and indicate that atypical lateralization may constitute a neurophenotype for clinically meaningful stratification in autism.
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Affiliation(s)
- Dorothea L Floris
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands; Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
| | - Thomas Wolfers
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands; Department of Psychology, University of Oslo, Norway; Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, University of Oslo Hospital and Oslo University Hospital, Oslo, Norway
| | - Mariam Zabihi
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands; Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Marcel P Zwiers
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Julian Tillmann
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria
| | - Christine Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt am Main, Goethe University, Frankfurt, Germany; Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Flavio Dell'Acqua
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Rosemary Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Durston
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eva Loth
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Declan G M Murphy
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Andre Marquand
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands; Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands; Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Jan K Buitelaar
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands; Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Christian F Beckmann
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands; Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands; Centre for Functional MRI of the Brain, University of Oxford, Oxford, United Kingdom
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17
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Scott KE, Schulz SE, Moehrle D, Allman BL, Oram Cardy JE, Stevenson RA, Schmid S. Closing the species gap: Translational approaches to studying sensory processing differences relevant for autism spectrum disorder. Autism Res 2021; 14:1322-1331. [PMID: 34003584 DOI: 10.1002/aur.2533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/01/2021] [Accepted: 05/04/2021] [Indexed: 12/26/2022]
Abstract
The study of sensory phenotypes has great potential for increasing research translation between species, a necessity to decipher the neural mechanisms that contribute to higher-order differences in neurological conditions such as autism spectrum disorder (ASD). Over the past decade, despite separate advances in our understanding of the structural and functional differences within the brain of autistic and non-autistic individuals and in rodent models for ASD, researchers have had difficulty translating the findings in murine species to humans, mostly due to incompatibility in experimental methodologies used to screen for ASD phenotypes. Focusing on sensory phenotypes offers an avenue to close the species gap because sensory pathways are highly conserved across species and are affected by the same risk-factors as the higher-order brain areas mostly responsible for the diagnostic criteria for ASD. By first reviewing how sensory processing has been studied to date, we direct our focus to electrophysiological and behavioral techniques that can be used to study sensory phenotypes consistently across species. Using auditory sensory phenotypes as a template, we seek to improve the accessibility of translational methods by providing a framework for collecting cohesive data in both rodents and humans. Specifically, evoked-potentials, acoustic startle paradigms, and psychophysical detection/discrimination paradigms can be created and implemented in a coordinated and systematic fashion across species. Through careful protocol design and collaboration, sensory processing phenotypes can be harnessed to bridge the gap that exists between preclinical animal studies and human testing, so that mutually held questions in autism research can be answered. LAY SUMMARY: It has always been difficult to relate results from animal research to humans. We try to close this gap by studying changes in sensory processing using careful protocol design and collaboration between clinicians and researchers. Sensory pathways are comparable between animals and humans, and are affected in the same way as the rest of the brain in ASD. Using changes in hearing as a template, we point the field in an innovative direction by providing a framework for collecting cohesive data in rodents and humans.
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Affiliation(s)
- Kaela E Scott
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Samantha E Schulz
- The Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - Dorit Moehrle
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Brian L Allman
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Janis E Oram Cardy
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Ryan A Stevenson
- The Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - Susanne Schmid
- Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,The Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
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18
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Gagnon D, Zeribi A, Douard É, Courchesne V, Rodríguez-Herreros B, Huguet G, Jacquemont S, Loum MA, Mottron L. Bayonet-shaped language development in autism with regression: a retrospective study. Mol Autism 2021; 12:35. [PMID: 33985558 PMCID: PMC8117564 DOI: 10.1186/s13229-021-00444-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 05/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language level and socio-communicative ability is uncertain. This study aimed to establish the predictive value of ELR on the progression of language development and socio-communicative outcomes to guide clinicians in addressing parents’ concerns at the time of diagnosis. Methods We used socio-communicative, language, and cognitive data of 2,047 autism spectrum participants from the Simons Simplex Collection, aged 4–18 years (mean = 9 years; SD = 3.6). Cox proportional hazard and logistic regression models were used to evaluate the effect of ELR on language milestones and the probability of using complex and flexible language, as defined by the choice of ADOS module at enrollment. Linear models were then used to evaluate the relationship of ELR and non-verbal IQ with socio-communicative and language levels. Results ELR is associated with earlier language milestones but delayed attainment of fluent, complex, and flexible language. However, this language outcome can be expected for almost all autistic children without intellectual disability at 18 years of age. It is mostly influenced by non-verbal IQ, not ELR. The language and socio-communicative level of participants with flexible language, as measured by the Vineland and ADOS socio-communicative subscales, was not affected by ELR. Limitations This study is based on a relatively coarse measure of ultimate language level and relies on retrospective reporting of early language milestones and ELR. It does not prospectively document the age at which language catches up, the relationship between ELR and other behavioral areas of regression, nor the effects of intervention. Conclusions For autistic individuals with ELR and a normal level of non-verbal intelligence, language development follows a “bayonet shape” trajectory: early first words followed by regression, a plateau with limited progress, and then language catch up. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00444-8.
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Affiliation(s)
- David Gagnon
- Research Center of the CIUSSS-NIM, Hôpital Rivière-Des-Prairies, 7070, Boul. Perras, Montreal, QC, H2E 1A4, Canada.,Department of psychiatry, University of Montreal, 2900 Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Abderrahim Zeribi
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,University of Sherbrooke, 2500, Boul. de L'Université, Sherbrooke, QC, J1K 2R1, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Élise Douard
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Valérie Courchesne
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, QC, H3A 2B4, Canada
| | - Borja Rodríguez-Herreros
- Centre Cantonal Autisme, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Avenue de Beaumont 23, 1011, Lausanne, Switzerland
| | - Guillaume Huguet
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Sébastien Jacquemont
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Mor Absa Loum
- University of Montreal, 2900, Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sainte-Justine Research Center, 3175, Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Laurent Mottron
- Research Center of the CIUSSS-NIM, Hôpital Rivière-Des-Prairies, 7070, Boul. Perras, Montreal, QC, H2E 1A4, Canada. .,Department of psychiatry, University of Montreal, 2900 Boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.
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19
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Which Factors Influence Teacher Report of Adaptive Functioning in Autistic Children? J Autism Dev Disord 2021; 52:463-472. [PMID: 33710469 PMCID: PMC8732898 DOI: 10.1007/s10803-021-04930-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2021] [Indexed: 11/16/2022]
Abstract
A wealth of parent-report research shows adaptive functioning difficulties in autistic children, with parent-report influenced by a number of child factors. Adaptive functioning in autistic children is known to vary across settings; however, no research has yet explored factors influencing education professional-report. This study investigated the rate and profile of impairment, and child factors influencing education professional-reported adaptive skills in 248 autistic children. Twelve children were < 3 years (min age for available normative data on the adaptive function measure), so were removed from the analyses. Results replicated parent-literature; adaptive skills were negatively associated with age and informant-reported autism severity, and positively associated with nonverbal ability and expressive language. Adaptive functioning is important for real-world outcomes, e.g. educational attainment, independence, and support needs. Improving our understanding of adaptive functioning in the education context may support opportunities for shared learning and enhance personalised support .
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20
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Lin PI, Moni MA, Gau SSF, Eapen V. Identifying Subgroups of Patients With Autism by Gene Expression Profiles Using Machine Learning Algorithms. Front Psychiatry 2021; 12:637022. [PMID: 34054599 PMCID: PMC8149626 DOI: 10.3389/fpsyt.2021.637022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/13/2021] [Indexed: 12/22/2022] Open
Abstract
Objectives: The identification of subgroups of autism spectrum disorder (ASD) may partially remedy the problems of clinical heterogeneity to facilitate the improvement of clinical management. The current study aims to use machine learning algorithms to analyze microarray data to identify clusters with relatively homogeneous clinical features. Methods: The whole-genome gene expression microarray data were used to predict communication quotient (SCQ) scores against all probes to select differential expression regions (DERs). Gene set enrichment analysis was performed for DERs with a fold-change >2 to identify hub pathways that play a role in the severity of social communication deficits inherent to ASD. We then used two machine learning methods, random forest classification (RF) and support vector machine (SVM), to identify two clusters using DERs. Finally, we evaluated how accurately the clusters predicted language impairment. Results: A total of 191 DERs were initially identified, and 54 of them with a fold-change >2 were selected for the pathway analysis. Cholesterol biosynthesis and metabolisms pathways appear to act as hubs that connect other trait-associated pathways to influence the severity of social communication deficits inherent to ASD. Both RF and SVM algorithms can yield a classification accuracy level >90% when all 191 DERs were analyzed. The ASD subtypes defined by the presence of language impairment, a strong indicator for prognosis, can be predicted by transcriptomic profiles associated with social communication deficits and cholesterol biosynthesis and metabolism. Conclusion: The results suggest that both RF and SVM are acceptable options for machine learning algorithms to identify AD subgroups characterized by clinical homogeneity related to prognosis.
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Affiliation(s)
- Ping-I Lin
- School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia.,South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Mohammad Ali Moni
- School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Valsamma Eapen
- School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia.,South Western Sydney Local Health District, Liverpool, NSW, Australia
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21
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Harrop C, Libsack E, Bernier R, Dapretto M, Jack A, McPartland JC, Van Horn JD, Webb SJ, Pelphrey K. Do Biological Sex and Early Developmental Milestones Predict the Age of First Concerns and Eventual Diagnosis in Autism Spectrum Disorder? Autism Res 2021; 14:156-168. [PMID: 33274604 PMCID: PMC8023413 DOI: 10.1002/aur.2446] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/26/2020] [Accepted: 11/15/2020] [Indexed: 11/09/2022]
Abstract
Despite advances in early detection, the average age of autism spectrum disorder (ASD) diagnosis exceeds 4 years and is often later in females. In typical development, biological sex predicts inter-individual variation across multiple developmental milestones, with females often exhibiting earlier progression. The goal of this study was to examine sex differences in caregiver-reported developmental milestones (first word, phrase, walking) and their contribution to timing of initial concerns expressed by caregivers and eventual age of diagnosis. 195 (105 males) children and adolescents aged 8 to 17 years with a clinical diagnosis of ASD were recruited to the study (mean IQ = 99.76). While developmental milestones did not predict timing of diagnosis or age parents first expressed concerns, females had earlier first words and phrases than males. There was a marginal difference in the age of diagnosis, with females receiving their diagnosis 1 year later than males. Despite sex differences in developmental milestones and diagnostic variables, IQ was the most significant predictor in the timing of initial concerns and eventual diagnosis, suggesting children with lower IQ, regardless of sex, are identified and diagnosed earlier. Overall, biological sex and developmental milestones did not account for a large proportion of variance for the eventual age of ASD diagnosis, suggesting other factors (such as IQ and the timing of initial concerns) are potentially more influential. LAY SUMMARY: In this study, a later age of diagnosis in females having ASD was confirmed; however, biological sex was not the stronger predictor of age of diagnosis. Parents reported that females learned language more quickly than males, and parents noted their first concerns when females were older than males. In this sample, the strongest predictor of age of diagnosis was the age of first concerns.
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Affiliation(s)
- Clare Harrop
- University of North Carolina at Chapel Hill, Allied Health Sciences, Carr Mill Mall, Carrboro, NC, 27510
| | - Erin Libsack
- Stony Brook University, Department of Psychology, Stony Brook, NY, 11794
| | - Raphael Bernier
- University of Washington Seattle, Department of Psychiatry and Behavioral Sciences, Seattle, WA, 98195
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development, Seattle, WA, 98121
| | - Mirella Dapretto
- University of California Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90024
| | - Allison Jack
- George Mason University, Department of Psychology, Fairfax, VA, 22030
| | - James C. McPartland
- Yale School of Medicine, Department of Pediatrics, New Haven, CT, 06520
- Yale School of Medicine, Yale Child Study Center, New Haven, CT, 06519
| | | | - Sara Jane Webb
- University of Washington Seattle, Department of Psychiatry and Behavioral Sciences, Seattle, WA, 98195
- Seattle Children’s Research Institute, Center on Child Health, Behavior and Development, Seattle, WA, 98121
| | - Kevin Pelphrey
- University of Virginia, Department of Neurology, Charlottesville, VA, 22903
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22
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Swanson MR. The role of caregiver speech in supporting language development in infants and toddlers with autism spectrum disorder. Dev Psychopathol 2020; 32:1230-1239. [PMID: 32893764 PMCID: PMC7872436 DOI: 10.1017/s0954579420000838] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Parents play an essential role in supporting child development by providing a safe home, proper nutrition, and rich educational opportunities. In this article we focus on the role of caregiver speech in supporting development of young children with autism spectrum disorder (ASD). We review studies from typically developing children and children with autism showing that rich and responsive caregiver speech supports language development. Autism intervention studies that target caregiver speech are reviewed as are recent scientific advances from studies of typical development. The strengths and weakness of different techniques for collecting language data from caregivers and children are reviewed, and natural language samples are recommended as best practice for language research in autism. We conclude that caregivers play a powerful role in shaping their children's development and encourage researchers to adapt parent-mediated intervention studies to acknowledge individual differences in parents by using a personalized medicine approach.
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Affiliation(s)
- Meghan R Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, TX, USA
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23
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Kodak T, Bergmann S. Autism Spectrum Disorder: Characteristics, Associated Behaviors, and Early Intervention. Pediatr Clin North Am 2020; 67:525-535. [PMID: 32443991 DOI: 10.1016/j.pcl.2020.02.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by deficits in social communication and interaction and the presence of restricted and repetitive patterns of behavior and interests. Currently, ASD affects 1 in 59 individuals and can be a costly disorder across one's lifetime. Because of the prevalence, costs, and range of behavioral needs, early intervention is vital to teach skills across a variety of domains and prevent the development or exacerbation of behavioral deficits and excesses. Interventions based on applied behavior analysis have the most empirical support; several strategies to teach social skills, communication, and adaptive skills are discussed.
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Affiliation(s)
- Tiffany Kodak
- Department of Psychology, Marquette University, 525 North 6th Street, Milwaukee, WI 53203, USA.
| | - Samantha Bergmann
- Department of Behavior Analysis, University of North Texas, 1155 Union Circle #310919, Denton, TX 76203-5017, USA
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24
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Choi B, Nelson CA, Rowe ML, Tager-Flusberg H. Reciprocal Influences Between Parent Input and Child Language Skills in Dyads Involving High- and Low-Risk Infants for Autism Spectrum Disorder. Autism Res 2020; 13:1168-1183. [PMID: 32003131 DOI: 10.1002/aur.2270] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/17/2019] [Accepted: 01/11/2020] [Indexed: 11/07/2022]
Abstract
We examined the language input of parents of infants at high and low familial risk for autism spectrum disorder (ASD) and investigated reciprocal associations between parent input and child language skills in the first 2 years of life. Parent-infant dyads (high-risk: n = 53; low-risk: n = 33), 19 of whom included an infant later diagnosed with ASD, were videotaped during free play interactions at 12, 18, and 24 months. Measures of parent input were derived from parent-child interactions. Children's language skills were assessed using the Mullen Scales of Early Learning at 12, 18, and 24 months. Results suggested that (a) parents of high- and low-risk infants produced similar word tokens, word types, and proportions of contingent verbal responses, but parents of high-risk infants used shorter mean length of utterances (MLU) than parents of low-risk infants at 18 and 24 months; (b) parents' MLU at 18 months was positively associated with their infants' language at the subsequent visit after 6 months, regardless of group; and (c) infants' language at 18 months was positively associated with parents' MLU at the subsequent visit after 6 months in the high-risk group only. These findings contribute to our understanding of the mechanisms underlying early language learning of high-risk infants who have an increased risk for language delays and deficits. Autism Res 2020, 13: 1168-1183. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Parents provide an important source of language input to their children. In this study, we looked at parent input to infants at high- and low-risk for autism spectrum disorder and relations between parent input and child language in the first 2 years of life. We found that parents of high- and low-risk infants provided similar quantity and quality of input, except shorter average length of utterances at 18 and 24 months in the high-risk group. Also, there were bidirectional relations between parent input and child language at 18 and 24 months in high-risk pairs, suggesting that parents and children collectively shape the early language environment.
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Affiliation(s)
- Boin Choi
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard Graduate School of Education, Cambridge, Massachusetts
| | - Charles A Nelson
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard Graduate School of Education, Cambridge, Massachusetts
| | - Meredith L Rowe
- Harvard Graduate School of Education, Cambridge, Massachusetts
| | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
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25
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Di Rezze B, Duku E, Szatmari P, Volden J, Georgiades S, Zwaigenbaum L, Smith IM, Vaillancourt T, Bennett TA, Elsabbagh M, Thompson A, Ungar WJ, Waddell C. Examining Trajectories of Daily Living Skills over the Preschool Years for Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 49:4390-4399. [PMID: 31372802 DOI: 10.1007/s10803-019-04150-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Preschool children with autism spectrum disorder (ASD) experience slower development of daily living skills (DLS) that are essential for independent functioning compared to typically developing children. Few studies have examined the trajectories of DLS in preschoolers with ASD and the existing literature has reported conflicting results. This study examined DLS trajectories and potential covariates for preschoolers with ASD from a multi-site longitudinal study following children from diagnosis to the end of grade 1. Multi-level modeling was conducted with DLS domain scores from the Vineland Adaptive Behavior Scales-2. The results demonstrated a positive trajectory of increasing scores over time, associations of age of diagnosis, developmental level, stereotypy, and language skills with the mean score at T4 or age 6 years, whereas rate of change was only associated with ASD symptom severity, such that an improvement in DLS trajectory was associated with lower and improving ASD symptom severity.
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Affiliation(s)
- B Di Rezze
- School of Rehabilitation Sciences, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, Room 436, 1400 Main St. W., Hamilton, ON, L8S 1C7, Canada.
| | - E Duku
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - P Szatmari
- Centre for Addiction and Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - J Volden
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - S Georgiades
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - L Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - I M Smith
- IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - T Vaillancourt
- Faculty of Education, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - T A Bennett
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - M Elsabbagh
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - A Thompson
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - W J Ungar
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - C Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
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26
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Mazurek MO, Baker-Ericzén M, Kanne SM. Brief Report: Calculation and Convergent and Divergent Validity of a New ADOS-2 Expressive Language Score. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 124:438-449. [PMID: 31512950 PMCID: PMC6800067 DOI: 10.1352/1944-7558-124.5.438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Despite the importance of expressive language for individuals with autism spectrum disorder (ASD), expressive language assessments are not consistently included in ASD research and many studies do not adequately describe participants' verbal abilities. A valid and efficient measure of expressive language would facilitate consistent reporting across ASD research studies and provide data for additional analyses. The current study developed a new Autism Diagnostic Observation Schedule (ADOS-2) expressive language score and examined convergent and divergent validity in a large, well-defined sample of children with ASD. This score was highly correlated with other measures of expressive language (including parent-report, direct assessment, and clinician ratings) and less strongly correlated with measures of receptive language and nonverbal cognitive ability, providing good evidence of convergent and divergent validity.
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Affiliation(s)
- Micah O Mazurek
- Micah O. Mazurek, Department of Human Services, University of Virginia; Mary Baker-Ericzén, Child and Adolescent Services Research Center, Rady Children's Hospital; and Stephen M. Kanne, Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri
| | - Mary Baker-Ericzén
- Micah O. Mazurek, Department of Human Services, University of Virginia; Mary Baker-Ericzén, Child and Adolescent Services Research Center, Rady Children's Hospital; and Stephen M. Kanne, Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri
| | - Stephen M Kanne
- Micah O. Mazurek, Department of Human Services, University of Virginia; Mary Baker-Ericzén, Child and Adolescent Services Research Center, Rady Children's Hospital; and Stephen M. Kanne, Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri
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27
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Swanson MR, Donovan K, Paterson S, Wolff JJ, Parish-Morris J, Meera SS, Watson LR, Estes AM, Marrus N, Elison JT, Shen MD, McNeilly HB, MacIntyre L, Zwaigenbaum L, St John T, Botteron K, Dager S, Piven J. Early language exposure supports later language skills in infants with and without autism. Autism Res 2019; 12:1784-1795. [PMID: 31254329 DOI: 10.1002/aur.2163] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/10/2019] [Indexed: 11/08/2022]
Abstract
The way that parents communicate with their typically developing infants is associated with later infant language development. Here we aim to show that these associations are observed in infants subsequently diagnosed with autism spectrum disorder (ASD). This study had three groups: high-familial-risk infants who did not have ASD (n = 46); high-familial-risk infants who had ASD (n = 14); and low-familial-risk infants who exhibited typical development (n = 36). All-day home language recordings were collected at 9 and 15 months, and language skills were assessed at 24 months. Across all infants in the study, including those with ASD, a richer home language environment (e.g., hearing more adult words and experiencing more conversational turns) at 9 and 15 months was associated with better language skills. Higher parental educational attainment was associated with a richer home language environment. Mediation analyses showed that the effect of education on child language skills was explained by the richness of the home language environment. Exploratory analyses revealed that typically developing infants experience an increase in caregiver-child conversational turns across 9-15 months, a pattern not seen in children with ASD. The current study shows that parent behavior during the earliest stages of life can have a significant impact on later development, highlighting the home language environment as means to support development in infants with ASD. Autism Res 2019, 12: 1784-1795. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: It has long been understood that caregiver speech supports language skills in typically developing infants. In this study, parents of infants who were later diagnosed with ASD and parents of infants in the control groups completed all-day home language recordings. We found that for all infants in our study, those who heard more caregiver speech had better language skills later in life. Parental education level was also related to how much caregiver speech an infant experienced.
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Affiliation(s)
- Meghan R Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas.,Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kevin Donovan
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sarah Paterson
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Julia Parish-Morris
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shoba S Meera
- Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Linda R Watson
- Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Natasha Marrus
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Mark D Shen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heidi B McNeilly
- Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leigh MacIntyre
- McGill Center for Integrative Neuroscience, McGill University, Montreal, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Canada.,Autism Research Centre (E209), Glenrose Rehabilitation Hospital, Edmonton, Canada
| | - Tanya St John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Kelly Botteron
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri.,Department of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, Washington
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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28
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Alagoz M, Kherad N, Gavaz M, Yuksel A. New Genetic Approaches for Early Diagnosis and Treatment of Autism Spectrum Disorders. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00167-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Ramseur K, de Vries PJ, Guler J, Shabalala N, Seris N, Franz L. Caregiver descriptions of joint activity routines with young children with autism spectrum disorder in South Africa. PEDIATRIC MEDICINE (HONG KONG, CHINA) 2019; 2:6. [PMID: 31032484 PMCID: PMC6481954 DOI: 10.21037/pm.2019.03.04] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Coaching caregivers to deliver Naturalistic Developmental Behavioral Intervention (NDBI) strategies to their young child with autism spectrum disorder (ASD) could help address the provider capacity barrier in sub-Saharan Africa. However, the behavioral and developmental research that underpins NDBIs is overwhelmingly drawn from high resource settings. Therefore, our understanding of joint activity routines, including play and family routines in which NDBI strategies are embedded, may have limited applicability in low resource, culturally diverse environments. Important questions remain on how to adapt NDBIs to be relevant in the family lives in these settings. This study aimed to elicit descriptions of joint activity routines from caregivers of young children with ASD in South Africa, to understand whether an NDBI-informed caregiver coaching could 'fit' within the multicultural, multilingual South African context. METHODS Four focus groups were conducted with 22 caregivers of young children with ASD who were recruited from the Western Cape Education Department autism waiting list. Data were analyzed through directed content analysis, which uses inductive methods to determine salient themes and subthemes. The predetermined initial coding classifications were based on joint activity routine categories of object-based play, sensory social routines, and family routines. RESULTS Participants' descriptions of caregiver-child interactions aligned with a-priori joint activity routine categories. During object-based play, caregivers engaged in turn-taking, taught developmental skills (for example cognitive, language, and fine motor skills), and participated in child-directed activities. During sensory social routines, caregivers described active, physical play, awareness of child affect, increased child expressive language, and willingness to engage with different play partners. During family routines, caregivers detailed child participation in mealtime and bath time. CONCLUSIONS These data suggest that South African caregivers of young children with ASD use joint activity routines to engage their children and teach them new skills, thus suggesting a degree of 'fit' between South African caregiver-child interactions and an NDBI-informed caregiver coaching approach. However, more information on family routines and which caregiver interacts with the young child with ASD during these routines would help tailor these interventions for low-resource African settings.
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Affiliation(s)
- Kevin Ramseur
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Petrus J. de Vries
- Centre for Autism Research in Africa, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Jessy Guler
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Nokuthula Shabalala
- Centre for Autism Research in Africa, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Noleen Seris
- Centre for Autism Research in Africa, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Lauren Franz
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Centre for Autism Research in Africa, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
- Duke Global Health Institute, Duke University, Durham, NC, USA
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30
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Barone R, Spampinato C, Pino C, Palermo F, Scuderi A, Zavattieri A, Gulisano M, Giordano D, Rizzo R. Online comprehension across different semantic categories in preschool children with autism spectrum disorder. PLoS One 2019; 14:e0211802. [PMID: 30742652 PMCID: PMC6370186 DOI: 10.1371/journal.pone.0211802] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/20/2019] [Indexed: 11/19/2022] Open
Abstract
Background Word comprehension across semantic categories is a key area of language development. Using online automated eye-tracking technology to reduce response demands during a word comprehension test may be advantageous in children with autism spectrum disorder (ASD). Objectives To measure online accuracy of word recognition across eleven semantic categories in preschool children with ASD and in typically developing (TD) children matched for gender and developmental age. Methods Using eye-tracker methodology we measured the relative number of fixations on a target image as compared to a foil of the same category shown simultaneously on screen. This online accuracy measure was considered a measure of word understanding. We tested the relationship between online accuracy and offline word recognition and the effects of clinical variables on online accuracy. Twenty-four children with ASD and 21 TD control children underwent the eye-tracking task. Results On average, children with ASD were significantly less accurate at fixating on the target image than the TD children. After multiple comparison correction, no significant differences were found across the eleven semantic categories of the experiment between preschool children with ASD and younger TD children matched for developmental age. The ASD group showed higher intragroup variability consistent with greater variation in vocabulary growth rates. Direct effects of non-verbal cognitive levels, vocabulary levels and gesture productions on online word recognition in both groups support a dimensional view of language abilities in ASD. Conclusions Online measures of word comprehension across different semantic categories show higher interindividual variability in children with ASD and may be useful for objectively monitor gains on targeted language interventions.
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Affiliation(s)
- Rita Barone
- Child Neurology and Psychiatry Unit—Department of Clinical and Experimental Medicine; University of Catania, Catania, Italy
- CNR-Institute for Polymers, Composites and Biomaterials IPCB, Catania, Italy
- * E-mail:
| | - Concetto Spampinato
- Department of Electrical, Electronic and Computer Engineering; University of Catania, Catania, Italy
| | - Carmelo Pino
- Department of Electrical, Electronic and Computer Engineering; University of Catania, Catania, Italy
| | - Filippo Palermo
- Biostatistics—Department of Clinical and Experimental Medicine; University of Catania, Catania, Italy
| | - Anna Scuderi
- School of Medicine, University of Catania, Catania, Italy
| | - Anna Zavattieri
- Child Neurology and Psychiatry Unit—Department of Clinical and Experimental Medicine; University of Catania, Catania, Italy
| | - Mariangela Gulisano
- Child Neurology and Psychiatry Unit—Department of Clinical and Experimental Medicine; University of Catania, Catania, Italy
| | - Daniela Giordano
- Department of Electrical, Electronic and Computer Engineering; University of Catania, Catania, Italy
| | - Renata Rizzo
- Child Neurology and Psychiatry Unit—Department of Clinical and Experimental Medicine; University of Catania, Catania, Italy
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31
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Bacon EC, Osuna S, Courchesne E, Pierce K. Naturalistic language sampling to characterize the language abilities of 3-year-olds with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:699-712. [PMID: 29754501 DOI: 10.1177/1362361318766241] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Characterization of language in naturalistic settings in autism spectrum disorder has been lacking, particularly at young ages, but such information is important for parents, teachers, and clinicians to better support language development in real-world settings. Factors contributing to this lack of clarity include conflicting definitions of language abilities, use of non-naturalistic standardized assessments, and restricted samples. The current study examined one of the largest datasets of naturalistic language samples in toddlers with autism spectrum disorder, and language delay and typically developing contrast groups at age 3. A range of indices including length of phrase, grammatical markings, and social use of language was assayed during a naturalistic observation of a parent-child play session. In contrast to historical estimates, results indicated only 3.7% of children with autism spectrum disorder used no words, and 34% were minimally verbal. Children with autism spectrum disorder and language delay exhibited similar usage of grammatical markings, although both were reduced compared to typically developing children. The greatest difference between autism spectrum disorder and language delay groups was the quantity of social language. Overall, findings highlight a range of language deficits in autism spectrum disorder, but also illustrate that the most severe level of impairments is not as common in naturalistic settings as previously estimated by standardized assessments.
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32
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The Effects of Early Language on Age at Diagnosis and Functioning at School Age in Children with Autism Spectrum Disorder. J Autism Dev Disord 2018; 47:2176-2188. [PMID: 28447306 DOI: 10.1007/s10803-017-3133-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Research suggests that toddlers with no language delay (NLD) should have better outcomes than those with language delay (LD). However, the predictive utility of language milestones relative to co-varying factors such as age at diagnosis, IQ, and ASD symptomatology is unclear. This study compared school-aged children with ASD and NLD (n = 59) to a well-matched group with ASD and LD (n = 59). The LD group was diagnosed at younger ages and their historical ASD symptoms were more severe than the NLD group. The groups were similar in current ASD symptoms and adaptive functioning at school age. Language milestones were correlated with adaptive functioning, but IQ and social symptoms of ASD were stronger predictors of functioning at school age. Therefore, language milestones may not be the best indicators of prognosis for children who are diagnosed after toddlerhood.
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33
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Kover ST, Edmunds SR, Ellis Weismer S. Brief Report: Ages of Language Milestones as Predictors of Developmental Trajectories in Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2017; 46:2501-7. [PMID: 26936159 DOI: 10.1007/s10803-016-2756-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Recognizing early risk markers in young children with autism spectrum disorder (ASD) is critical for timely diagnosis and intervention. The purpose of this study was to extend previous findings regarding language milestones to a longitudinal design, in which ages of expressive language milestones (i.e., first words, first phrases) could serve as predictors of developmental trajectories in a heterogeneous sample of young children with ASD (N = 98; age at first assessment: M = 32 months, SD = 5). Age of first words predicted trajectories of expressive language and adaptive skills; number of words predicted each outcome examined. Because these aspects of early language show promise as potential indicators of later functional outcomes, future research on developmental processes as they relate to individual differences will be particularly informative.
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Affiliation(s)
- Sara T Kover
- Department of Speech and Hearing Sciences, University of Washington, 1417 N.E. 42nd St., Seattle, WA, 98105, USA.
| | - Sarah R Edmunds
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Susan Ellis Weismer
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA.,Waisman Center, Madison, WI, USA
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34
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Brynskov C, Eigsti IM, Jørgensen M, Lemcke S, Bohn OS, Krøjgaard P. Syntax and Morphology in Danish-Speaking Children with Autism Spectrum Disorder. J Autism Dev Disord 2017; 47:373-383. [PMID: 27844246 DOI: 10.1007/s10803-016-2962-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The current study examined delays in syntax and morphology, and vocabulary, in autism spectrum disorder (ASD). Children ages 4-6 years with ASD (n = 21) and typical development (n = 21), matched on nonverbal mental age, completed five language tasks. The ASD group had significant delays in both syntax and morphology, and vocabulary measures, with significant within-group heterogeneity; furthermore, syntactic and morphological measures were impaired even for subgroups matched on vocabulary. Children in the ASD group without early language delay showed syntactic and morphological impairment, with intact performance on vocabulary and sentence repetition. Findings indicate that syntactic and morphological impairments are a significant concern for high-functioning children with ASD, and may be overlooked if language evaluation focuses exclusively on vocabulary.
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Affiliation(s)
- Cecilia Brynskov
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark.
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs, USA
| | - Meta Jørgensen
- Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
| | - Sanne Lemcke
- Centre for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
| | - Ocke-Schwen Bohn
- Department of English, Aarhus University, Aarhus, Denmark.,Center on Autobiographical Memory Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Peter Krøjgaard
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark.,Center on Autobiographical Memory Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
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35
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Subcortical Brain and Behavior Phenotypes Differentiate Infants With Autism Versus Language Delay. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:664-672. [PMID: 29560900 DOI: 10.1016/j.bpsc.2017.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Younger siblings of children with autism spectrum disorder (ASD) are themselves at increased risk for ASD and other developmental concerns. It is unclear if infants who display developmental concerns, but are unaffected by ASD, share similar or dissimilar behavioral and brain phenotypes to infants with ASD. Most individuals with ASD exhibit heterogeneous difficulties with language, and their receptive-expressive language profiles are often atypical. Yet, little is known about the neurobiology that contributes to these language difficulties. METHODS In this study, we used behavioral assessments and structural magnetic resonance imaging to investigate early brain structures and associations with later language skills. High-risk infants who were later diagnosed with ASD (n = 86) were compared with high-risk infants who showed signs of early language delay (n = 41) as well as with high- and low-risk infants who did not have ASD or language delay (n = 255 and 143, respectively). RESULTS Results indicated that diminished language skills were evident at 12 months in infants with ASD and infants with early language delay. At 24 months of age, only the infants with ASD displayed atypical receptive-expressive language profiles. Associations between 12-month subcortical volumes and 24-month language skills were moderated by group status, indicating disordinal brain-behavior associations among infants with ASD and infants with language delay. CONCLUSIONS These results suggest that there are different brain mechanisms influencing language development in infants with ASD and infants with language delay, and that the two groups likely experience unique sets of genetic and environmental risk factors.
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Ellawadi AB, Weismer SE. Using Spoken Language Benchmarks to Characterize the Expressive Language Skills of Young Children With Autism Spectrum Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2015; 24:696-707. [PMID: 26254475 PMCID: PMC4698469 DOI: 10.1044/2015_ajslp-14-0190] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 04/24/2015] [Accepted: 07/22/2015] [Indexed: 05/25/2023]
Abstract
PURPOSE Spoken language benchmarks proposed by Tager-Flusberg et al. (2009) were used to characterize communication profiles of toddlers with autism spectrum disorders and to investigate if there were differences in variables hypothesized to influence language development at different benchmark levels. METHOD The communication abilities of a large sample of toddlers with autism spectrum disorders (N = 105) were characterized in terms of spoken language benchmarks. The toddlers were grouped according to these benchmarks to investigate whether there were differences in selected variables across benchmark groups at a mean age of 2.5 years. RESULTS The majority of children in the sample presented with uneven communication profiles with relative strengths in phonology and significant weaknesses in pragmatics. When children were grouped according to one expressive language domain, across-group differences were observed in response to joint attention and gestures but not cognition or restricted and repetitive behaviors. CONCLUSION The spoken language benchmarks are useful for characterizing early communication profiles and investigating features that influence expressive language growth.
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Floris DL, Lai MC, Auer T, Lombardo MV, Ecker C, Chakrabarti B, Wheelwright SJ, Bullmore ET, Murphy DGM, Baron-Cohen S, Suckling J. Atypically rightward cerebral asymmetry in male adults with autism stratifies individuals with and without language delay. Hum Brain Mapp 2015; 37:230-53. [PMID: 26493275 PMCID: PMC4913747 DOI: 10.1002/hbm.23023] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/20/2015] [Accepted: 10/04/2015] [Indexed: 11/30/2022] Open
Abstract
In humans, both language and fine motor skills are associated with left‐hemisphere specialization, whereas visuospatial skills are associated with right‐hemisphere specialization. Individuals with autism spectrum conditions (ASC) show a profile of deficits and strengths that involves these lateralized cognitive functions. Here we test the hypothesis that regions implicated in these functions are atypically rightward lateralized in individuals with ASC and, that such atypicality is associated with functional performance. Participants included 67 male, right‐handed adults with ASC and 69 age‐ and IQ‐matched neurotypical males. We assessed group differences in structural asymmetries in cortical regions of interest with voxel‐based analysis of grey matter volumes, followed by correlational analyses with measures of language, motor and visuospatial skills. We found stronger rightward lateralization within the inferior parietal lobule and reduced leftward lateralization extending along the auditory cortex comprising the planum temporale, Heschl's gyrus, posterior supramarginal gyrus, and parietal operculum, which was more pronounced in ASC individuals with delayed language onset compared to those without. Planned correlational analyses showed that for individuals with ASC, reduced leftward asymmetry in the auditory region was associated with more childhood social reciprocity difficulties. We conclude that atypical cerebral structural asymmetry is a potential candidate neurophenotype of ASC. Hum Brain Mapp 37:230–253, 2016. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Dorothea L Floris
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Meng-Chuan Lai
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Tibor Auer
- MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Michael V Lombardo
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Christine Ecker
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Bhismadev Chakrabarti
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Sally J Wheelwright
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Edward T Bullmore
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.,Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,National Institute of Health Research, Cambridge Biomedical Research Centre, Cambridge, United Kingdom.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Declan G M Murphy
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - John Suckling
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.,Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,National Institute of Health Research, Cambridge Biomedical Research Centre, Cambridge, United Kingdom.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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Lai MC, Lombardo MV, Ecker C, Chakrabarti B, Suckling J, Bullmore ET, Happé F, Murphy DGM, Baron-Cohen S. Neuroanatomy of Individual Differences in Language in Adult Males with Autism. Cereb Cortex 2015; 25:3613-28. [PMID: 25249409 PMCID: PMC4585508 DOI: 10.1093/cercor/bhu211] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
One potential source of heterogeneity within autism spectrum conditions (ASC) is language development and ability. In 80 high-functioning male adults with ASC, we tested if variations in developmental and current structural language are associated with current neuroanatomy. Groups with and without language delay differed behaviorally in early social reciprocity, current language, but not current autistic features. Language delay was associated with larger total gray matter (GM) volume, smaller relative volume at bilateral insula, ventral basal ganglia, and right superior, middle, and polar temporal structures, and larger relative volume at pons and medulla oblongata in adulthood. Despite this heterogeneity, those with and without language delay showed significant commonality in morphometric features when contrasted with matched neurotypical individuals (n = 57). In ASC, better current language was associated with increased GM volume in bilateral temporal pole, superior temporal regions, dorsolateral fronto-parietal and cerebellar structures, and increased white matter volume in distributed frontal and insular regions. Furthermore, current language-neuroanatomy correlation patterns were similar across subgroups with or without language delay. High-functioning adult males with ASC show neuroanatomical variations associated with both developmental and current language characteristics. This underscores the importance of including both developmental and current language as specifiers for ASC, to help clarify heterogeneity.
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Affiliation(s)
- Meng-Chuan Lai
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge CB2 8AH, UK,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei 10051, Taiwan
| | - Michael V. Lombardo
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge CB2 8AH, UK,Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia CY 1678, Cyprus
| | - Christine Ecker
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, PO23, Institute of Psychiatry, London SE5 8AF, UK
| | - Bhismadev Chakrabarti
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge CB2 8AH, UK,School of Psychology and Clinical Language Sciences, Centre for Integrative Neuroscience and Neurodynamics, University of Reading, Reading RG6 6AL, UK
| | - John Suckling
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK
| | - Edward T. Bullmore
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK,GlaxoSmithKline, Clinical Unit Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK
| | - Francesca Happé
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, PO80, Institute of Psychiatry, London SE5 8AF, UK
| | | | - Declan G. M. Murphy
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, PO23, Institute of Psychiatry, London SE5 8AF, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge CB2 8AH, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK
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Brynskov C, Krøjgaard P, Eigsti IM. Language and communication in children with autism: Do research and clinical practice converge in Denmark? NORDIC PSYCHOLOGY 2015. [DOI: 10.1080/19012276.2015.1071199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Lord C, Bishop S, Anderson D. Developmental trajectories as autism phenotypes. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2015; 169:198-208. [PMID: 25959391 PMCID: PMC4898819 DOI: 10.1002/ajmg.c.31440] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Numerous studies of Autism Spectrum Disorder have attempted to link behavioral phenotypes to genetic findings. Reliance on cross-sectional behavioral data in samples that span wide age ranges may have limited this endeavor because ASD behaviors are not static within individuals across development. This study uses quantitative methods to describe specific aspects of changes in autism-related and more general behaviors in order to yield trajectories that could be used in place of single time-point data as behavioral phenotypes in neurobiological studies of both Autism Spectrum Disorders and overlapping conditions. Building on previous analyses, we examined trajectories of parent-reported social-communication deficits, social adaptive functioning, and two types of repetitive behaviors, repetitive sensory motor (RSM) behaviors and insistence on sameness (IS) behaviors, in a relatively large sample of participants referred for possible autism at age 2 years and followed into young adulthood (n=85). A strength of this sample was the diverse range of outcomes, including young adults with intellectual disability and persistent autism related difficulties, those with IQs in the borderline or average range who continued to experience functional impairment related to Autism Spectrum Disorders, and a small group of young adults (n=8) with IQs in the average range who were judged to be functioning socially and adaptively at age-appropriate levels at age 19 years, despite a previous childhood diagnosis of autism.
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Affiliation(s)
- Catherine Lord
- Center for Autism and the Developing Brain, Weill Cornell Medical College, USA
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McConachie H, Parr JR, Glod M, Hanratty J, Livingstone N, Oono IP, Robalino S, Baird G, Beresford B, Charman T, Garland D, Green J, Gringras P, Jones G, Law J, Le Couteur AS, Macdonald G, McColl EM, Morris C, Rodgers J, Simonoff E, Terwee CB, Williams K. Systematic review of tools to measure outcomes for young children with autism spectrum disorder. Health Technol Assess 2015; 19:1-506. [PMID: 26065374 PMCID: PMC4781156 DOI: 10.3310/hta19410] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children's progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness; skills such as social functioning and play; participation outcomes such as social inclusion; and parent and family impact. OBJECTIVES To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents. METHODS The MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013; systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD; and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers. RESULTS The conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains 'Impairments', 'Activity Level Indicators', 'Participation', and 'Family Measures'. In review 1, 10,154 papers were sifted - 3091 by full text - and data extracted from 184; in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed tools was combined with information about their accessibility and presentation. Twelve tools were identified as having the strongest supporting evidence, the majority measuring autism characteristics and problem behaviour. The patchy evidence and limited scope of outcomes measured mean these tools do not constitute a 'recommended battery' for use. In particular, there is little evidence that the identified tools would be good at detecting change in intervention studies. The obvious gaps in available outcome measurement include well-being and participation outcomes for children, and family quality-of-life outcomes, domains particularly valued by our informants (young people with ASD and parents). CONCLUSIONS This is the first systematic review of the quality and appropriateness of tools designed to monitor progress and outcomes of young children with ASD. Although it was not possible to recommend fully robust tools at this stage, the review consolidates what is known about the field and will act as a benchmark for future developments. With input from parents and other stakeholders, recommendations are made about priority targets for research. FUTURE WORK Priorities include development of a tool to measure child quality of life in ASD, and validation of a potential primary outcome tool for trials of early social communication intervention. STUDY REGISTRATION This study is registered as PROSPERO CRD42012002223. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Magdalena Glod
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Hanratty
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Nuala Livingstone
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Inalegwu P Oono
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Shannon Robalino
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian Baird
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Deborah Garland
- National Autistic Society North East Autism Resource Centre, Newcastle upon Tyne, UK
| | - Jonathan Green
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Paul Gringras
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Glenys Jones
- School of Education, University of Birmingham, Birmingham, UK
| | - James Law
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ann S Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Geraldine Macdonald
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Elaine M McColl
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Morris
- PenCRU, Child Health Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Jacqueline Rodgers
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Katrina Williams
- University of Melbourne, Royal Children's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia
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Thurm A, Manwaring SS, Swineford L, Farmer C. Longitudinal study of symptom severity and language in minimally verbal children with autism. J Child Psychol Psychiatry 2015; 56:97-104. [PMID: 24961159 PMCID: PMC4581593 DOI: 10.1111/jcpp.12285] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND A significant minority of children with autism spectrum disorder (ASD) are considered 'minimally verbal' due to language development stagnating at a few words. Recent developments allow for the severity of ASD symptoms to be examined using Autism Diagnostic Observation Schedule (ADOS) Social Affect (SA) and Restricted and Repetitive Behaviors (RRB) domain severity scores. The aim of the current study was to explore language outcomes in a cohort of minimally verbal children with autism evaluated through the preschool years and determine if and how ASD symptom severity in core domains predicts the development of spoken language by age 5. METHODS The sample consisted of 70 children with autism aged 1-5 years at the first evaluation who were examined at least 1 year later, during their fifth year of age. The ADOS overall level of language item was used to categorize children as minimally verbal or having phrase speech, and the Mullen Scales of Early Learning was used as a continuous measure of expressive language. RESULTS At Time 1, 65% (n = 47) of children in the sample were minimally verbal and by Time 2, 36% (n = 17 of 47) of them had developed phrase speech. While the Time 1 ADOS calibrated severity scores did not predict whether or not a child remained minimally verbal at Time 2, change in the SA calibrated severity score (but not RRB) was predictive of the continuous measure of expressive language. However, change in SA severity no longer predicted continuous expressive language when nonverbal cognitive ability was added to the model. CONCLUSIONS Findings indicate that the severity of SA symptoms has some relationship with continuous language outcome, but not categorical. However, the omnipresent influence of nonverbal cognitive ability was confirmed in the current study, as the addition of it to the model rendered null the predictive utility of SA severity.
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Narrative performance of optimal outcome children and adolescents with a history of an Autism Spectrum Disorder (ASD). J Autism Dev Disord 2014; 44:1681-94. [PMID: 24500659 DOI: 10.1007/s10803-014-2042-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Autism Spectrum Disorders (ASDs) have traditionally been considered a lifelong condition; however, a subset of people makes such significant improvements that they no longer meet diagnostic criteria for an ASD. The current study examines whether these "optimal outcome" (OO) children and adolescents continue to have subtle pragmatic language deficits. The narratives of 15 OO individuals, 15 high-functioning individuals with an ASD (HFA), and 15 typically developing (TD) peers were evaluated. Despite average cognitive functioning, the ASD group produced narratives with fewer central "gist" descriptions, more ambiguous pronominal referents, idiosyncratic language, speech dysfluency (more repetitions and self-corrections), and were less likely to name story characters. The OO participants displayed only very subtle pragmatic and higher-level language deficits (idiosyncratic language and self-correction dysfluency).
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Hudepohl MB, Robins DL, King TZ, Henrich CC. The role of emotion perception in adaptive functioning of people with autism spectrum disorders. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2013; 19:107-12. [PMID: 24335115 DOI: 10.1177/1362361313512725] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cognitive functioning has historically been used to predict adaptive outcomes of people with autism spectrum disorders; however, research shows that it is not a complete predictor. The current study explored whether emotion perception was a predictor of adaptive outcomes, and more specifically, hypothesized that emotion perception (Diagnostic Analysis of Nonverbal Accuracy-2 error scores) would mediate adaptive functioning of people with autism spectrum disorder (Vineland Adaptive Behavior Scales, Second Edition). People with autism spectrum disorders demonstrated significantly lower adaptive functioning and emotion perception skills compared to typically developing individuals. Emotion perception acted as a significant mediator for socialization, but not communication or daily living skills, highlighting that in people with autism spectrum disorders, lower socialization abilities is the result, in part, of emotion perception deficits. It was unexpected that emotion perception was not a mediator for communication skills. This may be related to sample restrictions, or the narrow focus on emotion perception. Future research should involve a larger, more inclusive autism spectrum disorder sample, broaden approaches to exploring relationships between social perception and adaptive outcomes, and relate findings to brain mechanisms underlying emotion perception.
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Eigsti IM, Fein DA. More is less: pitch discrimination and language delays in children with optimal outcomes from autism. Autism Res 2013; 6:605-13. [PMID: 23929787 DOI: 10.1002/aur.1324] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 07/03/2013] [Indexed: 11/07/2022]
Abstract
The autism spectrum disorders (ASD) are neurodevelopmental disorders diagnosed behaviorally but associated with differences in brain development. Individuals with ASD exhibit superior auditory perceptual skills, which may correlate with ASD symptomatology, particularly language skills. We describe findings from individuals diagnosed with ASD before age five, who now have no symptoms (e.g., having optimal outcomes). Unlike an ASD group, which shows heightened pitch discrimination, the Optimal Outcome group's abilities do not differ from those of typically developing controls. Furthermore, pitch discrimination is associated with both current autism symptomatology and early-language milestones. Findings illuminate processes associated with resolution of autism. We also discuss a specific mechanism by which heightened auditory discrimination leads to language delays in ASD.
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Affiliation(s)
- Inge-Marie Eigsti
- Department of Psychology, University of Connecticut, Storrs, Connecticut, USA
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Lindell AK, Hudry K. Atypicalities in Cortical Structure, Handedness, and Functional Lateralization for Language in Autism Spectrum Disorders. Neuropsychol Rev 2013; 23:257-70. [DOI: 10.1007/s11065-013-9234-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 04/23/2013] [Indexed: 12/19/2022]
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47
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Eigsti IM. A review of embodiment in autism spectrum disorders. Front Psychol 2013; 4:224. [PMID: 23641226 PMCID: PMC3639406 DOI: 10.3389/fpsyg.2013.00224] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 04/11/2013] [Indexed: 11/13/2022] Open
Abstract
In classical approaches to cognition, sensory, motor, and emotional experiences are stripped of domain-specific perceptual and sensorimotor information, and represented in a relatively abstract form. In contrast, the embodied cognition framework suggests that our representations retain the initial imprint of the manner in which information was acquired. In this paper, we argue that individuals with autism spectrum disorders (ASD) display impairments in the temporal coordination of motor and conceptual information (as shown in gesture research) and striking deficits in the interpersonal mimicry of motor behaviors (as shown in yawning research) - findings we believe are consistent with an embodied account of ASD that includes, but goes beyond, social experiences and is driven in part by significant but subtle motor deficits. In this paper, we review the research examining an embodied cognition account of ASD, and discuss its implications.
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