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Chen YJ, Sideris J, Watson LR, Crais ER, Baranek GT. Early developmental profiles of sensory features and links to school-age adaptive and maladaptive outcomes: A birth cohort investigation. Dev Psychopathol 2024; 36:291-301. [PMID: 36579629 PMCID: PMC10307924 DOI: 10.1017/s0954579422001195] [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] [Indexed: 12/30/2022]
Abstract
Sensory-based subtypes among autistic children have been well documented, but little is known about longitudinal sensory subtypes beyond autistic populations. This prospective study aimed to identify subtypes based on trajectories of parent-reported sensory features measured at 6-19 months, 3-4, and 6-7 years of age among a community-based birth cohort (N = 1,517), and to examine their associations with school-age clinical and adaptive/maladaptive outcomes on a subset sample (N = 389). Latent class growth analysis revealed five trajectory subtypes varying in intensity and change rates across three sensory domains. In contrast to an Adaptive-All Improving subtype (35%) with very low sensory features and overall better school-age outcomes, an Elevated-All Worsening subtype (3%), comprised of more boys and children of parents with less education, was associated with most elevated autistic traits and poorest adaptive/maladaptive outcomes. Three other subtypes (62% in total) were generally characterized by stable or improving patterns of sensory features at mild to moderate levels, and challenges in certain outcome domains. Our findings indicate that characterizing children based on early sensory trajectories may contribute to earlier detection of subgroups of children with sensory challenges who are more likely to experience developmental challenges by school age, followed by early targeted interventions for improved long-term outcomes.
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Affiliation(s)
- Yun-Ju Chen
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - John Sideris
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda R Watson
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth R Crais
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Grace T Baranek
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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2
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Campi E, Choi E, Chen YJ, Holland CM, Bristol S, Sideris J, Crais ER, Watson LR, Baranek GT. Sensory Reactivity of Infants at Elevated Likelihood of Autism and Associations with Caregiver Responsiveness. J Autism Dev Disord 2024; 54:270-279. [PMID: 36307744 PMCID: PMC9616418 DOI: 10.1007/s10803-022-05764-z] [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: 09/14/2022] [Indexed: 10/31/2022]
Abstract
Infants at elevated likelihood of developing autism display differences in sensory reactivity, especially hyporeactivity, as early as 7 months of age, potentially contributing to a developmental cascade of autism symptoms. Caregiver responsiveness, which has been linked to positive social communication outcomes, has not been adequately examined with regard to infant sensory reactivity. This study examined the multiplicative impact of infant sensory hypo- and hyperreactivity on caregiver responsiveness to sensory reactivity and regulation cues in 43 infants at elevated likelihood of autism. Sensory hyperreactivity was found to moderate the association between sensory hyporeactivity and caregiver responsiveness, such that caregivers of infants with moderately high sensory hypo- and hyperreactivity demonstrated higher responsiveness.
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Affiliation(s)
- Emily Campi
- University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, 90033, Los Angeles, CA, USA.
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA.
| | - Elizabeth Choi
- University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, 90033, Los Angeles, CA, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Yun-Ju Chen
- University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, 90033, Los Angeles, CA, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Cristin M Holland
- Department of Psychiatry, Columbia University Irving Medical Center, 630 W 168th St, 10032, New York, NY, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Stephanie Bristol
- Division of Occupational Science and Occupational Therapy, University of North Carolina Chapel Hill, Bondurant Hall, CB #7122, 27599-7122, Chapel Hill, NC, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - John Sideris
- University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, 90033, Los Angeles, CA, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Elizabeth R Crais
- Division of Speech and Hearing Sciences, University of North Carolina Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Linda R Watson
- Division of Speech and Hearing Sciences, University of North Carolina Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Grace T Baranek
- University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, 90033, Los Angeles, CA, USA
- Department of Health Sciences, University of North Carolina, Chapel Hill, NC, USA
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3
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Unwin KL, Barbaro J, Uljarevic M, Hussain A, Chetcuti M, Lane AE. The Sensory Observation Autism Rating Scale (SOAR): Developed using the PROMIS® framework. Autism Res 2023; 16:617-629. [PMID: 36565256 DOI: 10.1002/aur.2881] [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] [Received: 05/11/2022] [Accepted: 12/11/2022] [Indexed: 12/25/2022]
Abstract
Autistic people experience the sensory world differently, impacting behavior. First-hand accounts and group-based research have found that sensory differences impact a range of things including family life, anxiety, participation, and daily living. Early sensory differences are widely reported to be associated with a cascade of developmental difference, suggesting that early autism diagnosis and sensory mapping could enable the provision of supports to facilitate flourishing. However, appropriate measurement tools are not available as all rely on proxy report or are observation measures which include limited modalities or domains and require the administration of stimuli. Therefore, following the gold-standard recommendations for measurement development outlined by the PROMIS® framework, we created the Sensory Observation Autism Rating scale (SOAR). We identified sensory behaviors across all primary domains and modalities through an extensive autism-sensory literature review and from focus groups with autism stakeholders. The initial item bank was then refined by an expert panel and through video coding five-minutes of free play from Autism Diagnostic Observation Schedule assessments of 105 age- and gender-matched autistic and developmentally delayed children (aged 13-36 months; 38 female). An additional 25% of the sample were double coded to investigate interrater reliability. Observational data and expert review supported the reduction of the item bank to 37 items. We propose that the refined SOAR has excellent face and ecological validity, along with interrater reliability (Intraclass correlation = 0.87-0.99). Following further data collection and refinement, SOAR has promise to fully characterize sensory behaviors in autistic children and indicate useful supports.
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Affiliation(s)
- Katy L Unwin
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Mirko Uljarevic
- Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Azul Hussain
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Madison Chetcuti
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Alison E Lane
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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4
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Soler N, Cordier R, Perkes IE, Dale RC, Bray P. Proxy-reported sensory measures for children and adolescents with neurodevelopmental disorders: A systematic review. Dev Med Child Neurol 2023; 65:185-199. [PMID: 35906897 PMCID: PMC10952264 DOI: 10.1111/dmcn.15367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 01/04/2023]
Abstract
AIM To determine the quality and utility of proxy-reported sensory measures for children and adolescents with neurodevelopmental disorders (such as autism spectrum disorder, attention-deficit/hyperactivity disorder, movement disorders, and intellectual disability). METHOD We systematically searched 11 databases. We applied the updated Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist and criteria for good measurement properties to evaluate instrument development and psychometric properties. Findings were summarized using a COSMIN adaptation of Grading of Recommendations, Assessment, Development and Evaluations. RESULTS From 11 databases, 6748 articles were screened. Ninety-one full-length articles were reviewed after removing excluded studies and manual searches conducted by two reviewers. Data were extracted for 12 measures from 20 articles. Of the 12 measures, only three provided sufficient data to evaluate content validity and psychometric measurement properties. The Participation and Sensory Environment Questionnaire-Home (PSEQ-H) was the only measure that satisfied moderate content validity and moderate-to-high quality for measurement properties. These properties included: structural validity, hypothesis testing for construct validity, internal consistency, reliability, and measurement error. INTERPRETATION One measure, the PSEQ-H, met eight criteria for good measurement properties. To facilitate evidence-informed clinical decision-making, all psychometric properties of all 12 sensory-based, proxy-reported measures were presented. The importance of consumer engagement in measure development and the need for ongoing evaluation of measures against contemporaneous standards is recommended. WHAT THIS PAPER ADDS Three measures provided studies on content validity and psychometric measurement properties. The Participation and Sensory Environment Questionnaire-Home had moderate quality for content validity studies and high-to-moderate quality evidence for psychometric properties. The Participation and Sensory Environment Questionnaire was the only measure that included consumer involvement through qualitative interviews and pilot testing. Consumer involvement in measure development is important for content validity. Ongoing evaluation of measures against contemporaneous standards is recommended.
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Affiliation(s)
- Nicolette Soler
- School of Health SciencesUniversity of NewcastleNewcastleNSWAustralia
- Children’s Hospital Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
| | - Reinie Cordier
- Curtin School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWAAustralia
- Department of Social Work, Education and Community WellbeingNorthumbria UniversityNewcastleUK
| | - Iain E. Perkes
- School of Health SciencesUniversity of NewcastleNewcastleNSWAustralia
- Discipline of Psychiatry & Mental Health and Discipline of Paediatrics & Children’s Health, School of Clinical MedicineUniversity of New South Wales Medicine & Health, University of New South WalesSydneyNSWAustralia
- School of Women’s and Children’s Health, Faculty of Medicine and HealthUniversity of New South WalesSydneyNSWAustralia
| | - Russell C. Dale
- Children’s Hospital Westmead Clinical School, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- Department of Paediatric NeurologyThe Children's Hospital at WestmeadSydneyNSWAustralia
- Kids Neuroscience Centre, and Brain and Mind CentreUniversity of SydneySydneyNSWAustralia
| | - Paula Bray
- Sydney School of Health Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
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5
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Neuronal gating of tactile input and sleep in 10-month-old infants at typical and elevated likelihood for autism spectrum disorder. Sci Rep 2022; 12:14188. [PMID: 35986046 PMCID: PMC9391390 DOI: 10.1038/s41598-022-18018-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/04/2022] [Indexed: 12/23/2022] Open
Abstract
Sleep problems in Autism Spectrum Disorder (ASD) emerge early in development, yet the origin remains unclear. Here, we characterise developmental trajectories in sleep onset latency (SOL) and night awakenings in infants at elevated likelihood (EL) for ASD (who have an older sibling with ASD) and infants at typical likelihood (TL) for ASD. Further, we test whether the ability to gate tactile input, using an EEG tactile suppression index (TSI), associates with variation in SOL and night awakenings. Parent-reported night awakenings and SOL from 124 infants (97 at EL for ASD) at 5, 10 and 14 months were analyzed using generalized estimating equations. Compared to TL infants, infants at EL had significantly more awakenings and longer SOL at 10 and 14 months. The TSI predicted SOL concurrently at 10 months, independent of ASD likelihood status, but not longitudinally at 14 months. The TSI did not predict night awakenings concurrently or longitudinally. These results imply that infants at EL for ASD wake up more frequently during the night and take longer to fall asleep from 10 months of age. At 10 months, sensory gating predicts SOL, but not night awakenings, suggesting sensory gating differentially affects neural mechanisms of sleep initiation and maintenance.
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6
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Chan PLC, Poon MYC, Bux V, Wong SKF, Chu AWY, Louie FTM, Wang AQL, Yang HLC, Yu ELM, Fong SSL. Occupational therapy using an Ayres Sensory integration® approach for school-age children – a randomized controlled trial. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2022. [DOI: 10.1080/14473828.2022.2097814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Phoebe L. C. Chan
- Occupational Therapy Department, Integrated Rehabilitation Centre, 2/F, Tower A, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | | | - Vivian Bux
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, Hong Kong
| | - Shiren K. F. Wong
- Occupational Therapy Department, Castle Peak Hospital, Tuen Mun, N.T., Hong Kong
| | - Aileen W. Y. Chu
- Occupational Therapy Department, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Frances T. M. Louie
- Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Tai Po, N.T., Hong Kong
| | - Apple Q. L. Wang
- Occupational Therapy Department, Kowloon Hospital, Kowloon, Hong Kong
| | - Hellen L. C. Yang
- Occupational Therapy Department, Integrated Rehabilitation Centre, 2/F, Tower A, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | - Ellen L. M. Yu
- Clinical Research Centre, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Sanne S. L. Fong
- Occupational Therapy Department, Integrated Rehabilitation Centre, 2/F, Tower A, Hong Kong Children’s Hospital, Kowloon, Hong Kong
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7
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Dellapiazza F, Michelon C, Picot MC, Baghdadli A. A longitudinal exploratory study of changes in sensory processing in children with ASD from the ELENA cohort. Eur Child Adolesc Psychiatry 2022; 31:1-10. [PMID: 33660026 DOI: 10.1007/s00787-021-01746-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/12/2021] [Indexed: 12/26/2022]
Abstract
Atypical sensory processing (SP) is a diagnostic criterion of autism spectrum disorder (ASD). However, little is known about its course during development. In this exploratory longitudinal study, we aimed to investigate the course of SP among children with ASD and identify clinical variables associated with changes. We used a subsample of 51 children with confirmed ASD, aged from 3 to 10 years, recruited from the ELENA cohort. SP was assessed using the Sensory Profile questionnaire at baseline and three years later. Our preliminary results highlight the heterogeneity of the evolution of SP during the children's development and the existence of three subgroups based on the course of SP (improvement, stable, and worsening). In addition, the children's adaptive skills and maladaptive behaviors were related to the course of SP. These results could be confirmed in future studies with a larger sample size using a longitudinal approach to capture individual variability in SP. In addition, our results highlight the importance of accounting for temporal changes in the sensory needs of individuals with ASD in clinical practice.
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Affiliation(s)
- Florine Dellapiazza
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
| | - Cécile Michelon
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
| | - Marie-Christine Picot
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
- Department of Medical Information, University Hospital, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressources Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France.
- UVSQ, INSERM, CESP, Team DevPsy, Université Paris-Saclay, 94807, Villejuif, France.
- Faculté de Médecine, Université de Montpellier, Montpellier, France.
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8
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Bhat AN, Boulton AJ, Tulsky DS. A further study of relations between motor impairment and social communication, cognitive, language, functional impairments, and repetitive behavior severity in children with ASD using the SPARK study dataset. Autism Res 2022; 15:1156-1178. [PMID: 35357764 DOI: 10.1002/aur.2711] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/17/2022] [Accepted: 03/07/2022] [Indexed: 12/11/2022]
Abstract
Motor impairments are pervasive and persistent in children with autism spectrum disorder (ASD) throughout childhood and adolescence. Based on recent studies examining motor impairments in children with ASD between 5 and 15 years (i.e., SPARK study sample), 87-88% of this population is at-risk for a motor impairment, these problems persisted until 15 years, and related to their core (social communication skills and repetitive behaviors [RBs]) and comorbid (language, cognitive, and functional) impairments. Persistent motor impairments extending into adolescence/adulthood could negatively impact their independent daily living skills, physical fitness/activity levels, and physical/mental health. While multiple studies have examined relations between motor dimensions and core/comorbid impairments in young children with ASD, few studies have examined such relations in school-age children/adolescents with ASD. This paper conducts a further multidimensional study of which motor domains (i.e., gross-motor including visuo-motor or multilimb coordination/planning, fine motor [FM] or general coordination [GC] skills) best distinguish subgroups of school-age children/adolescents with ASD and help predict core and comorbid impairments after accounting for age and sex. Visuomotor, FM and certain GC skills were better at explaining variations in/predicting social communication impairments whereas FM skills were slightly better at explaining variations in/predicting RB severity. Multilimb coordination/planning and FM skills explained variations in/predicted cognitive delays whereas visuomotor and FM skills explained variations in and better predicted language delays. All three motor dimensions explained variations in/predicted functional delays. This study provides further evidence for inclusion of motor impairments within the ASD definition (criteria or specifiers). LAY SUMMARY: Gross-motor skills were related to social communication and functional delays of children with ASD (visuomotor skills related to language delays and multilimb coordination/planning skills related to cognitive delays). Fine-motor skills were related to repetitive behavior severity, language, cognitive, and functional delays in ASD. Diagnosticians should recommend systematic motor screening, further evaluations, and treatments for children at-risk for and diagnosed with ASD. Motor advocacy and enhanced public/clinical community awareness is needed to fulfill the unmet motor needs of children with ASD.
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Affiliation(s)
- Anjana N Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Aaron J Boulton
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA.,Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - David S Tulsky
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA.,Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
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9
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Su WC, Amonkar N, Cleffi C, Srinivasan S, Bhat A. Neural Effects of Physical Activity and Movement Interventions in Individuals With Developmental Disabilities-A Systematic Review. Front Psychiatry 2022; 13:794652. [PMID: 35242063 PMCID: PMC8886122 DOI: 10.3389/fpsyt.2022.794652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/03/2022] [Indexed: 01/21/2023] Open
Abstract
Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain structure and functioning. Physical activity/movement interventions improve behavioral performance of individuals with and without developmental disabilities. Majority of the evidence on potential neural mechanisms explaining the impact of physical activity/movement interventions is based on studies in individuals with typical development; there is a dearth of systematic reviews synthesizing the neural effects of physical activity/movement interventions in individuals with developmental disabilities. In this systematic review, we have gathered evidence on the neural effects of physical activity/movement interventions from 32 papers reporting substantial neural effects and behavioral improvements in individuals with developmental disabilities. Chronic intervention effects (multiple sessions) were greater than acute intervention effects (single session). Specifically, using electroencephalogram, functional magnetic resonance imaging, diffusion tensor imaging, and functional near-infrared spectroscopy, studies found physical activity/movement intervention-related changes in neural activity, indicating normalization of cortical arousal in individuals with attention-deficit /hyperactivity disorder (ADHD), increased social brain connectivity in individuals with autism spectrum disorder (ASD), and more efficient executive functioning processes in individuals with a wide range of other developmental disabilities. Despite promising results, more research is clearly needed in this area with larger sample sizes, using standardized neuroimaging tools/variables, and across multiple diagnoses to further explore the neural mechanisms underlying physical activity/movement interventions and to replicate findings from the present review.
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Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Corina Cleffi
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences (IBACS), University of Connecticut, Storrs, CT, United States
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
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10
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Amonkar N, Su WC, Bhat AN, Srinivasan SM. Effects of Creative Movement Therapies on Social Communication, Behavioral-Affective, Sensorimotor, Cognitive, and Functional Participation Skills of Individuals With Autism Spectrum Disorder: A Systematic Review. Front Psychiatry 2021; 12:722874. [PMID: 34867515 PMCID: PMC8637167 DOI: 10.3389/fpsyt.2021.722874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies (N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.
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Affiliation(s)
- Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
| | - Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Anjana N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Sudha M. Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
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11
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Bhat A. Analysis of the SPARK study COVID-19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services. Autism Res 2021; 14:2454-2470. [PMID: 34591364 PMCID: PMC8578426 DOI: 10.1002/aur.2618] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022]
Abstract
Children with ASD receive a multitude of educational, medical, and therapeutic services. At the onset of the COVID‐19 pandemic, all of these services came to a complete halt following strict lockdowns. Many services have resumed in a hybrid format using face to face and virtual modes of delivery. This study describes findings from the COVID‐19 impact survey administered at the onset of the pandemic in a subgroup of families from the SPARK cohort (N = 6393), one of the largest ASD cohorts in the US. The differential early impact of COVID‐19 on various subgroups of children with ASD and their families was examined. Caregivers of children and adolescents with ASD between 19 months and 18 years completed an online survey inquiring about the impact of COVID‐19 pandemic on access to services, parent concerns about the same, impact on child's ASD‐related behaviors, child, and parent mental health, and the benefits/potential benefits of online/future online services. Analysis revealed that certain demographic (age, income/SES) and child‐related factors (repetitive behaviors, language, functional, cognitive, and motor impairments, and child's understanding), as well as parent's past mental health were associated with/predicted greater service disruptions, greater ASD‐related behaviors, and greater negative impact on parent mental health. In conclusion, younger children, children from low‐income families, and children with greater impairment severity (more severe repetitive behaviors, language, cognitive, function, language, and motor impairments) were more negatively impacted by the pandemic through service disruptions, increased ASD‐related behaviors, parent health/family impact, and found online interactions to be less beneficial.
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Affiliation(s)
- Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
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12
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Zoccante L, Ciceri ML, Gozzi LA, Gennaro GD, Zerman N. The "Connectivome Theory": A New Model to Understand Autism Spectrum Disorders. Front Psychiatry 2021; 12:794516. [PMID: 35250650 PMCID: PMC8892379 DOI: 10.3389/fpsyt.2021.794516] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/23/2021] [Indexed: 12/20/2022] Open
Abstract
The classical approach to autism spectrum disorders (ASD) is often limited to considering their neuro-functional aspects. However, recent scientific literature has shown that ASDs also affect many body systems and apparatuses such as the immune system, the sensory-motor system, and the gut-brain axis. The connective tissue, a common thread linking all these structures, may have a pathogenetic role in the multisystem involvement of ASD. Depending on its different anatomical sites, the connective tissue performs functions of connection and support; furthermore, it acts as a barrier between the external and internal environments, regulating the interchange between the two and performing immunological surveillance. The connective tissue shares a close relationship with the central nervous system, the musculoskeletal system and the immune system. Alterations in brain connectivity are common to various developmental disorders, including ASD, and for this reason here we put forward the hypothesis that alterations in the physiological activity of microglia could be implicated in the pathogenesis of ASD. Also, muscle hypotonia is likely to clinically correlate with an altered sensoriality and, in fact, discomfort or early muscle fatigue are often reported in ASDs. Furthermore, patients with ASD often suffer from intestinal dysfunctions, malabsorption and leaky gut syndrome, all phenomena that may be linked to reduced intestinal connectivity. In addition, at the cutaneous and subcutaneous levels, ASDs show a greater predisposition to inflammatory events due to the lack of adequate release of anti-inflammatory mediators. Alveolar-capillary dysfunctions have also been observed in ASD, most frequently interstitial inflammations, immune-mediated forms of allergic asthma, and bronchial hyper-reactivity. Therefore, in autism, altered connectivity can result in phenomena of altered sensitivity to environmental stimuli. The following interpretative model, that we define as the "connectivome theory," considers the alterations in connective elements of common mesodermal origin located in the various organs and apparatuses and entails the evaluation and interpretation of ASDs through also highlighting somatic elements. We believe that this broader approach could be helpful for a more accurate analysis, as it is able to enrich clinical evaluation and define more multidisciplinary and personalized interventions.
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Affiliation(s)
- Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, Verona, Italy.,Autism Spectrum Disorders Regional Centre of Verona, Verona, Italy
| | - Marco Luigi Ciceri
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, Verona, Italy.,Autism Spectrum Disorders Regional Centre of Verona, Verona, Italy
| | - Luigi Alberto Gozzi
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, Verona, Italy.,Autism Spectrum Disorders Regional Centre of Verona, Verona, Italy
| | - Gianfranco Di Gennaro
- Department of Pathology and Diagnostics, Integrated University Hospital Verona, Verona, Italy
| | - Nicoletta Zerman
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
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13
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Ciarrusta J, Dimitrova R, Batalle D, O'Muircheartaigh J, Cordero-Grande L, Price A, Hughes E, Kangas J, Perry E, Javed A, Demilew J, Hajnal J, Edwards AD, Murphy D, Arichi T, McAlonan G. Emerging functional connectivity differences in newborn infants vulnerable to autism spectrum disorders. Transl Psychiatry 2020; 10:131. [PMID: 32376820 PMCID: PMC7203016 DOI: 10.1038/s41398-020-0805-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/16/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022] Open
Abstract
Studies in animal models of autism spectrum disorders (ASD) suggest atypical early neural activity is a core vulnerability mechanism which alters functional connectivity and predisposes to dysmaturation of neural circuits. However, underlying biological changes associated to ASD in humans remain unclear. Results from functional connectivity studies of individuals diagnosed with ASD are highly heterogeneous, in part because of complex life-long secondary and/or compensatory events. To minimize these confounds and examine primary vulnerability mechanisms, we need to investigate very early brain development. Here, we tested the hypothesis that brain functional connectivity is altered in neonates who are vulnerable to this condition due to a family history of ASD. We acquired high temporal resolution multiband resting state functional magnetic resonance imaging (fMRI) in newborn infants with and without a first-degree relative with ASD. Differences in local functional connectivity were quantified using regional homogeneity (ReHo) analysis and long-range connectivity was assessed using distance correlation analysis. Neonates who have a first-degree relative with ASD had significantly higher ReHo within multiple resting state networks in comparison to age matched controls; there were no differences in long range connectivity. Atypical local functional activity may constitute a biomarker of vulnerability, that might precede disruptions in long range connectivity reported in older individuals diagnosed with ASD.
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Affiliation(s)
- Judit Ciarrusta
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
| | - Ralica Dimitrova
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
| | - Dafnis Batalle
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
| | - Jonathan O'Muircheartaigh
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, United Kingdom
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
| | - Anthony Price
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
| | - Emer Hughes
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
| | - Johanna Kangas
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
| | - Emily Perry
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
| | - Ayesha Javed
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
| | - Jill Demilew
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Joseph Hajnal
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
| | - Anthony David Edwards
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, United Kingdom
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Declan Murphy
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Tomoki Arichi
- Centre for the Developing Brain, School Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, United Kingdom.
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, United Kingdom.
| | - Grainne McAlonan
- Dept. of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AB, United Kingdom.
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, SE1 1UL, United Kingdom.
- South London and Maudsley NHS Foundation Trust, London, United Kingdom.
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14
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Ben-Sasson A, Gal E, Fluss R, Katz-Zetler N, Cermak SA. Update of a Meta-analysis of Sensory Symptoms in ASD: A New Decade of Research. J Autism Dev Disord 2020; 49:4974-4996. [PMID: 31501953 DOI: 10.1007/s10803-019-04180-0] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This meta-analysis updated evidence regarding sensory over-responsivity (SOR), under-responsivity (SUR) and seeking symptoms in individuals with autism spectrum disorders (ASDs) relative to typical controls and those with other conditions. Fifty-five questionnaire studies included 4606 individuals with ASD. Moderators tested were age, IQ, male ratio, matching group, and self-report. Compared to typical controls, effect size was large and significant for SOR, SUR, and Seeking but heterogeneous. For Seeking, age, IQ and self-report were significant moderators. Compared with developmental disorders (DDs) groups, effect size was significantly positive for SOR and Seeking; whereas compared with other clinical groups, only SOR was significant. These findings highlight the core nature of sensory symptoms in ASD and particularly SOR. Explanatory factors are yet to be revealed.
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Affiliation(s)
- Ayelet Ben-Sasson
- Occupational Therapy Department, University of Haifa, Abba Khoushy Ave 199, 3498838, Haifa, Israel.
| | - Eynat Gal
- Occupational Therapy Department, University of Haifa, Abba Khoushy Ave 199, 3498838, Haifa, Israel
| | - Ronen Fluss
- Biostatistics and Biomathematics Department, The Gertner Institute, Chaim Sheba Medical Center, 52621, Tel Hashomer, Israel
| | - Neta Katz-Zetler
- Occupational Therapy Department, University of Haifa, Abba Khoushy Ave 199, 3498838, Haifa, Israel
| | - Sharon A Cermak
- Chan Division of Occupational Science and Occupational Therapy, University of South California, 1540 Alcazar St., CHP 133, Los Angeles, CA, 90089-900, USA
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15
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Soler N, Hardwick C, Perkes IE, Mohammad SS, Dossetor D, Nunn K, Bray P, Dale RC. Sensory dysregulation in tic disorders is associated with executive dysfunction and comorbidities. Mov Disord 2019; 34:1901-1909. [PMID: 31505086 DOI: 10.1002/mds.27817] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/04/2019] [Accepted: 07/19/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Tics are conceptualized as a sensorimotor phenomenon with a premonitory urge typically described by patients. As observed in other neurodevelopmental disorders, we have observed sensory dysregulation symptoms, such as tactile hypersensitivity to clothing, in children with tic disorders; however, formal clinical research in this area is limited. OBJECTIVE To define the presence of sensory dysregulation symptoms in tic disorders, and their clinical associations. METHODS Prevalence of sensory dysregulation in 102 children with tic disorders was compared to 61 age- and sex-matched healthy controls. Sensory dysregulation, executive function, and quality of life data were obtained through the Short Sensory Profile-2, Sensory Profile-2, Sensory Processing Measure, Behaviour Rating Inventory of Executive Function-2, and Strength and Difficulties Questionnaire and Pediatric Quality of Life Inventory. Tics were assessed with the Yale Global Tic Severity Scale. RESULTS Children with tics, in the presence of comorbidity, had elevated sensory dysregulation compared to healthy controls (P < 0.001). There was a positive correlation between sensory dysregulation and global executive difficulties in children with tics and comorbidity (n = 87; rho = 0.716; P < 0.001) and a negative correlation of sensory dysregulation with quality of life (n = 87; rho = -0.595; P < 0.001). In children with tics, there was an association between sensory dysregulation and number of comorbidities (P < 0.001). CONCLUSION In the presence of comorbidity, children with tic disorders have broad sensory dysregulation symptoms beyond the premonitory urge. There was a statistically significant association between sensory dysregulation and executive function difficulties and the presence of neurodevelopmental and psychiatric comorbidity. Sensory dysregulation can be considered neurodevelopmental symptoms, providing insight into the neurobiology of tics and opportunities for therapeutic intervention. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Nicolette Soler
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Chris Hardwick
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Iain E Perkes
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,The University of New South Wales, School of Psychiatry, Faculty of Medicine, & School of Psychology, Faculty of Science, Sydney, Australia
| | - Shekeeb S Mohammad
- Department of Pediatric Neurology, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - David Dossetor
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Paula Bray
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Russell C Dale
- Department of Pediatric Neurology, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Kids Neuroscience Centre, and Brain and Mind Centre, Sydney, Australia
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16
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Bhat AN, McDonald NM, Eilbott JE, Pelphrey KA. Exploring cortical activation and connectivity in infants with and without familial risk for autism during naturalistic social interactions: A preliminary study. Infant Behav Dev 2019; 57:101337. [PMID: 31450025 DOI: 10.1016/j.infbeh.2019.101337] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/09/2019] [Accepted: 07/01/2019] [Indexed: 11/29/2022]
Abstract
Behavioral signs of Autism Spectrum Disorder (ASD) are typically observable by the second year of life and a reliable diagnosis of ASD is possible by 2 to 3 years of age. Studying infants with familial risk for ASD allows for the investigation of early signs of ASD risk within the first year. Brain abnormalities such as hyper-connectivity within the first year may precede the overt signs of ASD that emerge later in life. In this preliminary study, we use functional near-infrared spectroscopy (fNIRS), an infant-friendly neuroimaging tool that is relatively robust against motion artifacts, to examine functional activation and connectivity during naturalistic social interactions in 9 high-risk (HR; older sibling with ASD) and 6 low-risk (LR; no family history of ASD) infants from 6 to 9 months of age. We obtained two 30-second baseline periods and a 5-minute social interaction period. HR infants showed reduced right and left-hemispheric activation compared to LR infants based on oxy (HbO2) and deoxy (HHb) signal trends. HR infants also had greater functional connectivity than LR infants during the pre- and post-social periods and showed a drop in connectivity during the social period. Our findings are consistent with previous work suggesting early differences in cortical activation associated with familial risk for ASD, and highlight the promise of fNIRS in evaluating potential markers of ASD risk during naturalistic social contexts.
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Affiliation(s)
- A N Bhat
- Department of Physical Therapy, University of Delaware, 540 S College Ave., Newark, DE, USA; Department of Psychological & Brain Sciences, University of Delaware, 320 McKinly Lab, Newark, DE, USA; Biomechanics & Movement Science Program, University of Delaware, 540 S College Ave., Newark, DE, USA.
| | - N M McDonald
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA, USA
| | - J E Eilbott
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | - K A Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
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17
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Srinivasan SM, Bhat AN. Differences in means-end exploration between infants at risk for autism and typically developing infants in the first 15 months of life. Dev Psychobiol 2018; 61:203-215. [PMID: 30511480 DOI: 10.1002/dev.21810] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/19/2018] [Accepted: 10/26/2018] [Indexed: 12/22/2022]
Abstract
Our study compared means-end exploration in infants at risk (AR) for autism and typically developing (TD) infants using a nested box paradigm. Sixteen AR and 16 TD infants were observed at 9, 12, and 15 months with follow-up at 18 and 24 months. We collected video data on three tasks involving retrieval of a small toy by opening (a) an opaque box, (b) a transparent box, and (c) two nested boxes. Dependent variables included hand bias, time to completion, bilateral hand use, problem-solving strategies used, and tester assistance required. There were no group differences in terms of hand biases. Compared to TD infants, AR infants had lower bilateral hand use, poor problem solving skills, and required greater assistance. Both groups demonstrated age-related improvements in motor and cognitive skills. Means-end exploration provides a window into the bilateral coordination and motor planning/problem-solving abilities of young infants at risk for autism. Lastly, object retrieval tasks could serve as important learning contexts for at-risk infants.
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Affiliation(s)
- Sudha M Srinivasan
- IDC School of Design, Indian Institute of Technology Bombay, Mumbai, India.,Department of Kinesiology, Physical Therapy Program, University of Connecticut, Storrs, Connecticut
| | - Anjana N Bhat
- Department of Kinesiology, Physical Therapy Program, University of Connecticut, Storrs, Connecticut.,Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware
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