1
|
Wallis KE, Guthrie W. Screening for Autism: A Review of the Current State, Ongoing Challenges, and Novel Approaches on the Horizon. Pediatr Clin North Am 2024; 71:127-155. [PMID: 38423713 DOI: 10.1016/j.pcl.2023.12.003] [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] [Indexed: 03/02/2024]
Abstract
Screening for autism is recommended in pediatric primary care. However, the median age of autism spectrum disorder (ASD) diagnosis is substantially higher than the age at which autism can reliably be identified, suggesting room for improvements in autism recognition at young ages, especially for children from minoritized racial and ethnic groups, low-income families, and families who prefer a language other than English. Novel approaches are being developed to utilize new technologies in aiding in autism recognition. However, attention to equity is needed to minimize bias. Additional research on the benefits and potential harms of universal autism screening is needed. The authors provide suggestions for pediatricians who are considering implementing autism-screening programs.
Collapse
Affiliation(s)
- Kate E Wallis
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Whitney Guthrie
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
2
|
Marrus N, Botteron KN, Hawks Z, Pruett JR, Elison JT, Jackson JJ, Markson L, Eggebrecht AT, Burrows CA, Zwaigenbaum L, Dager S, Estes A, Hazlett H, Schultz RT, Piven J, Constantino JN. Social motivation in infancy is associated with familial recurrence of ASD. Dev Psychopathol 2024; 36:101-111. [PMID: 36189644 PMCID: PMC10067534 DOI: 10.1017/s0954579422001006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Pre-diagnostic deficits in social motivation are hypothesized to contribute to autism spectrum disorder (ASD), a heritable neurodevelopmental condition. We evaluated psychometric properties of a social motivation index (SMI) using parent-report item-level data from 597 participants in a prospective cohort of infant siblings at high and low familial risk for ASD. We tested whether lower SMI scores at 6, 12, and 24 months were associated with a 24-month ASD diagnosis and whether social motivation's course differed relative to familial ASD liability. The SMI displayed good internal consistency and temporal stability. Children diagnosed with ASD displayed lower mean SMI T-scores at all ages and a decrease in mean T-scores across age. Lower group-level 6-month scores corresponded with higher familial ASD liability. Among high-risk infants, strong decline in SMI T-scores was associated with 10-fold odds of diagnosis. Infant social motivation is quantifiable by parental report, differentiates children with versus without later ASD by age 6 months, and tracks with familial ASD liability, consistent with a diagnostic and susceptibility marker of ASD. Early decrements and decline in social motivation indicate increased likelihood of ASD, highlighting social motivation's importance to risk assessment and clarification of the ontogeny of ASD.
Collapse
Affiliation(s)
- Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine
| | | | - Zoë Hawks
- Department of Psychological & Brain Sciences, Washington University in St. Louis
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota
| | - Joshua J. Jackson
- Department of Psychological & Brain Sciences, Washington University in St. Louis
| | - Lori Markson
- Department of Psychological & Brain Sciences, Washington University in St. Louis
| | - Adam T. Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine
| | | | | | | | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington
| | - Heather Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | | | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | | | | |
Collapse
|
3
|
Demchick BB, Flanagan J, Li CY, Cassidy R, Golding J. Early Indicators of Autism in Infants: Development of the IMES Screening Tool. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:255-263. [PMID: 36495161 DOI: 10.1177/15394492221134910] [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: 12/14/2022]
Abstract
We developed the Infant, Motor, and Engagement Scale (IMES) to address the public health goal of early identification of autism spectrum disorder (ASD). The IMES is a screening tool that assesses quality of infants' interaction with people and objects during early play. We aimed to examine the IMES' preliminary psychometric properties and its value in discriminating between infants later diagnosed with ASD and typically developing infants. We used the IMES to score retrospective home videos of 15 male infants, 7 who were later diagnosed with autism. We examined interrater reliability using Cohen's Kappa, internal consistency with Cronbach's alpha and content validity through expert review. Preliminary data support validity and reliability of the IMES for early identification for infants at 6 to 9 months. With further research, the IMES has the potential to identify at risk infants at a young age that may have long-term impact on child and family outcomes.
Collapse
Affiliation(s)
| | | | - Chih-Ying Li
- The University of Texas Medical Branch, Galveston, USA
| | | | | |
Collapse
|
4
|
Dawson G, Rieder AD, Johnson MH. Prediction of autism in infants: progress and challenges. Lancet Neurol 2023; 22:244-254. [PMID: 36427512 PMCID: PMC10100853 DOI: 10.1016/s1474-4422(22)00407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/17/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
Autism spectrum disorder (henceforth autism) is a neurodevelopmental condition that can be reliably diagnosed in children by age 18-24 months. Prospective longitudinal studies of infants aged 1 year and younger who are later diagnosed with autism are elucidating the early developmental course of autism and identifying ways of predicting autism before diagnosis is possible. Studies that use MRI, EEG, and near-infrared spectroscopy have identified differences in brain development in infants later diagnosed with autism compared with infants without autism. Retrospective studies of infants younger than 1 year who received a later diagnosis of autism have also showed an increased prevalence of health conditions, such as sleep disorders, gastrointestinal disorders, and vision problems. Behavioural features of infants later diagnosed with autism include differences in attention, vocalisations, gestures, affect, temperament, social engagement, sensory processing, and motor abilities. Although research findings offer insight on promising screening approaches for predicting autism in infants, individual-level predictions remain a future goal. Multiple scientific challenges and ethical questions remain to be addressed to translate research on early brain-based and behavioural predictors of autism into feasible and reliable screening tools for clinical practice.
Collapse
Affiliation(s)
- Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Amber D Rieder
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Cambridge, UK; Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
| |
Collapse
|
5
|
Sterrett K, Magaña MT, Gulsrud A, Paparella T, Kasari C. Predictors of Attrition in a Randomized Trial of a Social Communication Intervention for Infant-Toddlers at Risk for Autism. J Autism Dev Disord 2022:10.1007/s10803-022-05616-w. [PMID: 35678946 DOI: 10.1007/s10803-022-05616-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
Addressing factors that make it more likely for families to attrite from early intervention trials will allow researchers to ensure that families reap the full benefits of participation. This study was an analysis of 78 children (Mage = 18.38 months, SD = 5.78) at risk for autism participating in a university-based randomized controlled trial of two 8-week long early intervention programs. Overall, attrition through 8-weeks was low, approximately 13%, however by the one-year follow-up attrition rates were approximately 50%. The most consistent predictor of attrition was the distance that families had to travel to the university. These data highlight the importance of providing services and support (e.g., financial and logistic) during follow-up to families to maximize their participation. Clincaltrials.gov Identifier: NCT01874327, 6/11/2013.
Collapse
Affiliation(s)
- Kyle Sterrett
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States. .,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza 68-262B, 90024, Los Angeles, CA, United States.
| | - Maira Tafolla Magaña
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
| | - Amanda Gulsrud
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
| | - Tanya Paparella
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
| | - Connie Kasari
- Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, 90024, Los Angeles, CA, United States
| |
Collapse
|
6
|
Joyce EE, Chavarro JE, Rando J, Song AY, Croen LA, Fallin MD, Hertz‐Picciotto I, Schmidt RJ, Volk H, Newschaffer CJ, Lyall K. Prenatal exposure to pesticide residues in the diet in association with child autism-related traits: Results from the EARLI study. Autism Res 2022; 15:957-970. [PMID: 35261202 PMCID: PMC9090949 DOI: 10.1002/aur.2698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/31/2022]
Abstract
Prior work has suggested associations between prenatal exposure to several classes of pesticides and child autism spectrum disorder (ASD). We examined a previously developed pesticide residue burden score (PRBS) and intake of high pesticide residue foods in association with ASD-related traits. Participants were drawn from the Early Autism Risk Longitudinal Investigation (EARLI) (n = 256), a cohort following mothers who previously had a child with ASD through a subsequent pregnancy and that child's development. ASD-related traits were captured according to total Social Responsiveness Scale (SRS) scores at age 3 (mean raw total SRS score = 35.8). Dietary intake was assessed through a food frequency questionnaire collected during pregnancy. We also incorporated organic intake and fatty foods in modified versions of the PRBS. Associations between high-residue fruit and vegetable intake, the overall PRBS and modified versions of it, and SRS scores were assessed using multivariable linear regression. Overall, we did not observe associations between pesticide residues in foods and ASD-related outcomes, and modified versions of the PRBS yielded similar findings. However, reductions in ASD-related traits were observed with higher overall fruit and vegetable intake (adjusted estimates for Q4 vs. Q1: β -12.76, 95%CI -27.8, 2.3). Thus, findings from this high familial probability cohort did not suggest relationships between pesticide residues in the diet according to the PRBS and ASD-related traits. Beneficial effects of fruit and vegetable intake may influence these relationships. Future work should consider fruit and vegetable intake in association with ASD-related outcomes. LAY SUMMARY: Diet is the main source of exposure to most pesticides in use today. In this study, we examined the relationship between pesticide exposure from residues in the diet during pregnancy and child autism-related traits. We found that these pesticide residues from the diet were not related to child autism-related outcomes at age three. However, higher prenatal fruit and vegetable intake was associated with reductions in child autism-related traits.
Collapse
Affiliation(s)
- Emily E. Joyce
- Dornsife School of Public Health, Department of Epidemiology and BiostatisticsDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Jorge E. Chavarro
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Juliette Rando
- A.J. Drexel Autism InstituteDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Ashley Y. Song
- Department of Mental HealthJohns HopkinsBaltimoreMarylandUSA
| | - Lisa A. Croen
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCaliforniaUSA
| | | | - Irva Hertz‐Picciotto
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
- MIND InstituteSacramentoCAUSA
| | - Rebecca J. Schmidt
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
- MIND InstituteSacramentoCAUSA
| | - Heather Volk
- Department of Mental HealthJohns HopkinsBaltimoreMarylandUSA
| | - Craig J. Newschaffer
- College of Health and Human DevelopmentPenn State, University Park, State CollegePennsylvaniaUSA
| | - Kristen Lyall
- Dornsife School of Public Health, Department of Epidemiology and BiostatisticsDrexel UniversityPhiladelphiaPennsylvaniaUSA
- A.J. Drexel Autism InstituteDrexel UniversityPhiladelphiaPennsylvaniaUSA
| |
Collapse
|
7
|
Grzadzinski R, Amso D, Landa R, Watson L, Guralnick M, Zwaigenbaum L, Deák G, Estes A, Brian J, Bath K, Elison J, Abbeduto L, Wolff J, Piven J. Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda. J Neurodev Disord 2021; 13:49. [PMID: 34654371 PMCID: PMC8520312 DOI: 10.1186/s11689-021-09393-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/16/2021] [Indexed: 12/26/2022] Open
Abstract
Autism spectrum disorder (ASD) impacts an individual's ability to socialize, communicate, and interact with, and adapt to, the environment. Over the last two decades, research has focused on early identification of ASD with significant progress being made in understanding the early behavioral and biological markers that precede a diagnosis, providing a catalyst for pre-symptomatic identification and intervention. Evidence from preclinical trials suggest that intervention prior to the onset of ASD symptoms may yield more improved developmental outcomes, and clinical studies suggest that the earlier intervention is administered, the better the outcomes. This article brings together a multidisciplinary group of experts to develop a conceptual framework for behavioral intervention, during the pre-symptomatic period prior to the consolidation of symptoms into diagnosis, in infants at very-high-likelihood for developing ASD (VHL-ASD). The overarching goals of this paper are to promote the development of new intervention approaches, empirical research, and policy efforts aimed at VHL-ASD infants during the pre-symptomatic period (i.e., prior to the consolidation of the defining features of ASD).
Collapse
Affiliation(s)
- Rebecca Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA.
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA.
| | - Dima Amso
- Department of Psychology, Columbia University, New York, NY, USA
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Linda Watson
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA
- Division of Speech and Hearing Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Michael Guralnick
- Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | | | - Gedeon Deák
- Department of Cognitive Science, University of California, San Diego, San Diego, CA, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington Autism Center, University of Washington, Seattle, WA, USA
| | - Jessica Brian
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Kevin Bath
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Jed Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Leonard Abbeduto
- University of California, Davis, MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Jason Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
8
|
Talbott MR, Dufek S, Young G, Rogers SJ. Leveraging telehealth to evaluate infants with prodromal autism spectrum disorder characteristics using the telehealth evaluation of development for infants. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1242-1254. [PMID: 34549613 DOI: 10.1177/13623613211045596] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Many families seeking early evaluations for autism spectrum disorder face long waitlists, must often travel to centers with appropriate expertise, and are frequently told by providers to "wait and see." This results in significant stress for families and delayed supports to infants and their caregivers who could benefit. This study evaluated whether telehealth could be used to identify and evaluate infants with early autism spectrum disorder characteristics in the first year of life. In this study, we evaluated 41 infants via telehealth using a standard set of probes and scored behavior related to social communication, play, imitation, and other developmental domains. We found the majority of infants demonstrated elevated likelihood of autism spectrum disorder on both parent-reported questionnaires and examiner-rated behavior. Caregiver ratings of the overall utility of the protocol used in this study were high. Overall, this study demonstrates the feasibility for telehealth-based approaches to evaluate infants' with elevated likelihood of autism spectrum disorder in the first year of life, which could help to improve families' access to care and to expand our capacity to conduct studies evaluating possible intervention supports.
Collapse
|
9
|
Di Giorgio E, Rosa-Salva O, Frasnelli E, Calcagnì A, Lunghi M, Scattoni ML, Simion F, Vallortigara G. Abnormal visual attention to simple social stimuli in 4-month-old infants at high risk for Autism. Sci Rep 2021; 11:15785. [PMID: 34349200 PMCID: PMC8338945 DOI: 10.1038/s41598-021-95418-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/22/2021] [Indexed: 11/23/2022] Open
Abstract
Despite an increasing interest in detecting early signs of Autism Spectrum Disorders (ASD), the pathogenesis of the social impairments characterizing ASD is still largely unknown. Atypical visual attention to social stimuli is a potential early marker of the social and communicative deficits of ASD. Some authors hypothesized that such impairments are present from birth, leading to a decline in the subsequent typical functioning of the learning-mechanisms. Others suggested that these early deficits emerge during the transition from subcortically to cortically mediated mechanisms, happening around 2–3 months of age. The present study aimed to provide additional evidence on the origin of the early visual attention disturbance that seems to characterize infants at high risk (HR) for ASD. Four visual preference tasks were used to investigate social attention in 4-month-old HR, compared to low-risk (LR) infants of the same age. Visual attention differences between HR and LR infants emerged only for stimuli depicting a direct eye-gaze, compared to an adverted eye-gaze. Specifically, HR infants showed a significant visual preference for the direct eye-gaze stimulus compared to LR infants, which may indicate a delayed development of the visual preferences normally observed at birth in typically developing infants. No other differences were found between groups. Results are discussed in the light of the hypotheses on the origins of early social visual attention impairments in infants at risk for ASD.
Collapse
Affiliation(s)
- Elisa Di Giorgio
- Dipartimento Di Psicologia Dello Sviluppo E Della Socializzazione, Università Degli Studi Di Padova, Via Venezia 8, 35131, Padova, PD, Italy.
| | - Orsola Rosa-Salva
- CIMeC, Center for Mind/Brain Sciences, University of Trento, Mattarello, Italy
| | | | - Antonio Calcagnì
- Dipartimento Di Psicologia Dello Sviluppo E Della Socializzazione, Università Degli Studi Di Padova, Via Venezia 8, 35131, Padova, PD, Italy
| | - Marco Lunghi
- Dipartimento Di Psicologia Dello Sviluppo E Della Socializzazione, Università Degli Studi Di Padova, Via Venezia 8, 35131, Padova, PD, Italy
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Rome, Italy
| | - Francesca Simion
- Dipartimento Di Psicologia Dello Sviluppo E Della Socializzazione, Università Degli Studi Di Padova, Via Venezia 8, 35131, Padova, PD, Italy
| | | |
Collapse
|
10
|
Godel M, Andrews DS, Amaral DG, Ozonoff S, Young GS, Lee JK, Wu Nordahl C, Schaer M. Altered Gray-White Matter Boundary Contrast in Toddlers at Risk for Autism Relates to Later Diagnosis of Autism Spectrum Disorder. Front Neurosci 2021; 15:669194. [PMID: 34220428 PMCID: PMC8248433 DOI: 10.3389/fnins.2021.669194] [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] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/18/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Recent neuroimaging studies have highlighted differences in cerebral maturation in individuals with autism spectrum disorder (ASD) in comparison to typical development. For instance, the contrast of the gray-white matter boundary is decreased in adults with ASD. To determine how gray-white matter boundary integrity relates to early ASD phenotypes, we used a regional structural MRI index of gray-white matter contrast (GWC) on a sample of toddlers with a hereditary high risk for ASD. MATERIALS AND METHODS We used a surface-based approach to compute vertex-wise GWC in a longitudinal cohort of toddlers at high-risk for ASD imaged twice between 12 and 24 months (n = 20). A full clinical assessment of ASD-related symptoms was performed in conjunction with imaging and again at 3 years of age for diagnostic outcome. Three outcome groups were defined (ASD, n = 9; typical development, n = 8; non-typical development, n = 3). RESULTS ASD diagnostic outcome at age 3 was associated with widespread increases in GWC between age 12 and 24 months. Many cortical regions were affected, including regions implicated in social processing and language acquisition. In parallel, we found that early onset of ASD symptoms (i.e., prior to 18-months) was specifically associated with slower GWC rates of change during the second year of life. These alterations were found in areas mainly belonging to the central executive network. LIMITATIONS Our study is the first to measure maturational changes in GWC in toddlers who developed autism, but given the limited size of our sample results should be considered exploratory and warrant further replication in independent and larger samples. CONCLUSION These preliminary results suggest that ASD is linked to early alterations of the gray-white matter boundary in widespread brain regions. Early onset of ASD diagnosis constitutes an independent clinical parameter associated with a specific corresponding neurobiological developmental trajectory. Altered neural migration and/or altered myelination processes potentially explain these findings.
Collapse
Affiliation(s)
- Michel Godel
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Derek S. Andrews
- Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - David G. Amaral
- Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Sally Ozonoff
- Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Gregory S. Young
- Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Joshua K. Lee
- Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Christine Wu Nordahl
- Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Marie Schaer
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| |
Collapse
|
11
|
Tanner A, Dounavi K. The Emergence of Autism Symptoms Prior to 18 Months of Age: A Systematic Literature Review. J Autism Dev Disord 2021; 51:973-993. [PMID: 32734422 DOI: 10.1007/s10803-020-04618-w/tables/3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Pre-diagnostic intervention for autism spectrum disorder (ASD) allows symptoms to be addressed as they emerge, often between six to 18 months, rather than after the full onset of the disorder. A systematic literature review, spanning the previous six years was conducted in order to provide an updated review looking at the earliest behavior symptoms of ASD. All included studies used a prospective experimental design, reported on symptoms that emerged before 18-months of age, exclusively in children who would later receive a diagnosis, and were assessed for quality. This review is the first to address this research question through the use of a systematic research design and extends the literature by following up on recommendations for future research from previous findings.
Collapse
Affiliation(s)
- Amy Tanner
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| | - Katerina Dounavi
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| |
Collapse
|
12
|
Tanner A, Dounavi K. The Emergence of Autism Symptoms Prior to 18 Months of Age: A Systematic Literature Review. J Autism Dev Disord 2021; 51:973-993. [PMID: 32734422 PMCID: PMC7954747 DOI: 10.1007/s10803-020-04618-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pre-diagnostic intervention for autism spectrum disorder (ASD) allows symptoms to be addressed as they emerge, often between six to 18 months, rather than after the full onset of the disorder. A systematic literature review, spanning the previous six years was conducted in order to provide an updated review looking at the earliest behavior symptoms of ASD. All included studies used a prospective experimental design, reported on symptoms that emerged before 18-months of age, exclusively in children who would later receive a diagnosis, and were assessed for quality. This review is the first to address this research question through the use of a systematic research design and extends the literature by following up on recommendations for future research from previous findings.
Collapse
Affiliation(s)
- Amy Tanner
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| | - Katerina Dounavi
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| |
Collapse
|
13
|
Editorial S.I: Early Identification in Autism Spectrum Disorders: The Present and Future, and Advances in Early Identification. J Autism Dev Disord 2021; 51:763-768. [PMID: 33483912 PMCID: PMC7954717 DOI: 10.1007/s10803-020-04860-2] [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: 12/23/2020] [Indexed: 12/15/2022]
Abstract
Early identification of autism spectrum disorder (ASD) is considered by most scholars and clinicians to be a feasible and useful step for improving the wellbeing of individuals on the autism spectrum and their families. Arguments supporting early detection efforts include the benefit of earlier access to services providing autism-specific evidence-based interventions (Vivanti et al., Journal of Autism and Developmental Disorders, 46(7), 2441-2449, 2016; Zwaigenbaum et al., Pediatrics, 136(Suppl), S10-S40, 2015), and its potential to mitigate or even prevent the challenges associated with ASD symptoms, reduce care costs, and improve the quality of life and productivity of individuals with ASD (Constantino et al., Pediatrics, 146(3), e20193629, 2020; Jacobson et al., Behavioral Interventions, 13(4), 201-226, 1998; Jacobson and Mulick, Journal of Autism and Developmental Disorders, 30(6), 585-593, 2000). Nevertheless, controversies and challenges in this field exist.
Collapse
|