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Riboldi EM, Capelli E, Cantiani C, Beretta C, Molteni M, Riva V. Differentiating early sensory profiles in toddlers at elevated likelihood of autism and association with later clinical outcome and diagnosis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1654-1666. [PMID: 37795823 PMCID: PMC11191663 DOI: 10.1177/13623613231200081] [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: 10/06/2023]
Abstract
LAY ABSTRACT Early sensory responsiveness may produce cascading effects on later development, but the relation between sensory profiles and autistic diagnosis remains unclear. In a longitudinal sample of toddlers at elevated likelihood for autism, we aimed to characterize sensory subgroups and their association with clinical outcomes later on. Three sensory subgroups were described and early sensory sensitivity plays a significant role in later development and diagnosis. This study supported the importance of examining different levels of sensory patterns to dissect the phenotypic heterogeneity in sensory processing. As sensory differences are associated with later developmental outcomes, these results may be critical when designing intervention needs and support for children at increased likelihood for neurodevelopmental disorders.
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Affiliation(s)
| | - Elena Capelli
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Chiara Cantiani
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Carolina Beretta
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Massimo Molteni
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Valentina Riva
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
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Li T, Xiong Q, Shi R, Yi L. Autistic and Non-autistic Children's Pain Perception is Modulated by Their First-Hand Pain Sensitivity and Theory of Mind. Res Child Adolesc Psychopathol 2024; 52:1173-1182. [PMID: 38345657 DOI: 10.1007/s10802-024-01176-y] [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: 01/31/2024] [Indexed: 07/03/2024]
Abstract
The current study examined whether autistic children's perception of others' pain could be modulated by their first-hand pain sensitivity and theory of mind (ToM). We measured the first-hand pain sensitivity, the rating of others' pain intensity, and the performance in the ToM tasks in 43 5- to 8-year-old autistic and 30 neurotypical children. Our results revealed hyposensitivity to first-hand pain, underestimation of others' pain intensity, as well as difficulties in the False Belief subtasks of ToM in autistic children. Furthermore, we detected an interaction between children's first-hand pain sensitivity and ToM in predicting their perception of others' pain. To be specific, for autistic and NT children with normal or hyper-sensitivity to first-hand pain, better performance on ToM predicted higher ratings for others' pain intensity; while for autistic and NT children with hyposensitivity to first-hand pain, ToM did not predict ratings for others' pain intensity. Our study contributes to the understanding of pain perception in young children and provides implications for clinical practices to improve social understanding in autistic children.
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Affiliation(s)
- Tianbi Li
- School of Psychological and Cognitive Sciences & Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Qianhan Xiong
- Department of Counseling Psychology, Social Psychology, and Counseling, Ball State University, Muncie, IN, USA
| | - Ruoxi Shi
- Qingdao Autism Research Institute, Qingdao, Shandong, China
| | - Li Yi
- School of Psychological and Cognitive Sciences & Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
- IDG/McGovern Institute for Brain Research at PKU Peking University, Peking University, Beijing, China.
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3
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Dwyer P, Sillas A, Prieto M, Camp E, Nordahl CW, Rivera SM. Hyper-focus, sticky attention, and springy attention in young autistic children: Associations with sensory behaviors and cognitive ability. Autism Res 2024. [PMID: 38840328 DOI: 10.1002/aur.3174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
The autistic-developed monotropism account suggests that atypical, domain-general attentional hyper-focus on interests is a central aspect of autism, but domain-general attention differences in autism can manifest differently. Prior research suggests autistic children are often slow to disengage attention from stimuli-a pattern often called "sticky attention"-and that they can show reduced novelty preference. These attentional patterns could influence sensory experiences and learning. We used eye-tracking to investigate novelty preference and "sticky attention" in young autistic children; we also examined whether attentional patterns were related to cognitive abilities and caregiver-reported sensory responsiveness. A total of 46 autistic and 28 nonautistic participants, aged between 2 and 4 years, provided usable data. We found no evidence that autistic children exhibited greater "sticky attention" than nonautistics, but "sticky attention" in autism was associated with more caregiver-reported sensory hyper-responsiveness, seeking/interests, and enhanced perception. Autistic children also nonsignificantly trended toward exhibiting reduced novelty preference. Unexpectedly, the time-course of this trending novelty preference difference implied it was not driven by reduced orienting to novelty, but increased returning to already-familiarized stimuli: what we call "springy attention." Exploratory analyses of data from the attentional disengagement task suggest autistic participants may have exhibited greater "springy attention," though further research with paradigms optimized for measuring this construct should confirm this. Importantly, "springy attention" was robustly related to reduced cognitive abilities and greater caregiver-reported hypo-responsiveness. Thus, this study illuminates two distinct domain-general attentional patterns, each with distinct correlates in young autistic children, which could have important implications for understanding autistic children's learning, development, and experiences.
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Affiliation(s)
- Patrick Dwyer
- Center for Mind and Brain, University of California, Davis, Davis, California, USA
- Department of Psychology, University of California, Davis, Davis, California, USA
- MIND Institute, UC Davis Health, Sacramento, California, USA
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Andre Sillas
- Center for Mind and Brain, University of California, Davis, Davis, California, USA
| | - Melanie Prieto
- Center for Mind and Brain, University of California, Davis, Davis, California, USA
- Department of Psychology, University of California, Santa Cruz, California, USA
| | - Emily Camp
- Center for Mind and Brain, University of California, Davis, Davis, California, USA
- Department of Psychology, University of California, Davis, Davis, California, USA
| | - Christine Wu Nordahl
- MIND Institute, UC Davis Health, Sacramento, California, USA
- Department of Psychiatry and Behavioral Sciences, UC Davis Health, Sacramento, CA, USA
| | - Susan M Rivera
- Center for Mind and Brain, University of California, Davis, Davis, California, USA
- Department of Psychology, University of California, Davis, Davis, California, USA
- MIND Institute, UC Davis Health, Sacramento, California, USA
- Department of Psychology, University of Maryland, College Park, Maryland, USA
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4
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Worthley E, Grzadzinski R, Zwaigenbaum L, Dager SR, Estes AM, Hazlett HC, Schultz RT, Piven J, Wolff JJ. Sensory Profiles in Relation to Later Adaptive Functioning Among Toddlers at High-Familial Likelihood for Autism. J Autism Dev Disord 2024; 54:2183-2197. [PMID: 37017863 DOI: 10.1007/s10803-022-05869-5] [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: 12/10/2022] [Indexed: 04/06/2023]
Abstract
This study investigated the extent to which sensory responsivity in infancy contributes to adaptive behavior development among toddlers at high-familial likelihood for autism. Prospective, longitudinal data were analyzed for 218 children, 58 of whom received an autism diagnosis. Results indicated that sensory profiles at age one year (hyperresponsivity, sensory seeking) were negatively associated with later adaptive behavior, particularly for socialization, at age 3 years regardless of diagnostic status. These results suggest that early differences in sensory responsivity may have downstream developmental consequences related to social development among young children with high-familial likelihood for autism.
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Affiliation(s)
- Emma Worthley
- University of Minnesota, 56 East River Road, 55455, Minneapolis, MN, USA
| | - Rebecca Grzadzinski
- University of North Carolina at Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
| | | | - Stephen R Dager
- University of Washington, 1701 NE Columbia Rd, 98195, Seattle, WA, USA
| | - Annette M Estes
- University of Washington, 1701 NE Columbia Rd, 98195, Seattle, WA, USA
| | - Heather C Hazlett
- University of North Carolina at Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
| | - Robert T Schultz
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, 19104, Philadelphia, PA, USA
| | - Joseph Piven
- University of North Carolina at Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
| | - Jason J Wolff
- University of Minnesota, 56 East River Road, 55455, Minneapolis, MN, USA.
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Heffler KF, Acharya B, Subedi K, Bennett DS. Early-Life Digital Media Experiences and Development of Atypical Sensory Processing. JAMA Pediatr 2024; 178:266-273. [PMID: 38190175 PMCID: PMC10775079 DOI: 10.1001/jamapediatrics.2023.5923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/30/2023] [Indexed: 01/09/2024]
Abstract
Importance Atypical sensory processing is challenging for children and families, yet there is limited understanding of its associated risk factors. Objective To determine the association between early-life digital media exposure and sensory processing outcomes among toddlers. Design, Setting, and Participants This multicenter US study used data that were analyzed from the National Children's Study (NCS), a cohort study of environmental influences on child health and development, with enrollment from 2011 to 2014. Data analysis was performed in 2023. The study included children enrolled in the NCS at birth whose caregivers completed reports of digital media exposure and sensory processing. Exposures Children's viewing of television or video at 12 months (yes or no), 18 months, and 24 months of age (hours per day). Main Outcomes and measures Sensory processing was reported at approximately 33 months of age on the Infant/Toddler Sensory Profile. Quadrant scores (low registration, sensation seeking, sensory sensitivity, and sensation avoiding) were categorized into groups representing typical, high, and low sensory-related behaviors, and multinomial regression analyses were performed. Results A total of 1471 children (50% male) were included. Screen exposure at 12 months of age was associated with a 2-fold increased odds of being in the high category of low registration (odds ratio [OR], 2.05; 95% CI, 1.31-3.20), while the odds of being in the low category instead of the typical category decreased for sensation seeking (OR, 0.55; 95% CI, 0.35-0.87), sensation avoiding (OR, 0.69; 95% CI, 0.50-0.94), and low registration (OR, 0.64; 95% CI, 0.44-0.92). At 18 months of age, greater screen exposure was associated with increased risk of high sensation avoiding (OR, 1.23; 95% CI, 1.03-1.46) and low registration (OR, 1.23; 95% CI, 1.04-1.44). At 24 months of age, greater screen exposure was associated with increased risk of high sensation seeking (OR, 1.20; 95% CI, 1.02-1.42), sensory sensitivity (OR, 1.25; 95% CI, 1.05-1.49), and sensation avoiding (OR, 1.21; 95% CI, 1.03-1.42). Conclusions and Relevance In this cohort study, early-life digital media exposure was associated with atypical sensory processing outcomes in multiple domains. These findings suggest that digital media exposure might be a potential risk factor for the development of atypical sensory profiles. Further research is needed to understand the relationship between screen time and specific sensory-related developmental and behavioral outcomes, and whether minimizing early-life exposure can improve subsequent sensory-related outcomes.
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Affiliation(s)
- Karen Frankel Heffler
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania
- Tower Health, West Reading, Pennsylvania
| | - Binod Acharya
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania
| | - Keshab Subedi
- Institute for Research on Equity and Community Health (iREACH), Christiana Care Health Systems, Newark, Delaware
| | - David S Bennett
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania
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Feldman JI, Garla V, Dunham K, Markfeld JE, Bowman SM, Golden AJ, Daly C, Kaiser S, Mailapur N, Raj S, Santapuram P, Suzman E, Augustine AE, Muhumuza A, Cascio CJ, Williams KL, Kirby AV, Keceli-Kaysili B, Woynaroski TG. Longitudinal Relations Between Early Sensory Responsiveness and Later Communication in Infants with Autistic and Non-autistic Siblings. J Autism Dev Disord 2024; 54:594-606. [PMID: 36441431 PMCID: PMC9707174 DOI: 10.1007/s10803-022-05817-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/29/2022]
Abstract
Early differences in sensory responsiveness may contribute to difficulties with communication among autistic children; however, this theory has not been longitudinally assessed in infants at increased familial versus general population-level likelihood for autism (Sibs-autism vs. Sibs-NA) using a comprehensive battery of sensory responsiveness and communication. In a sample of 40 infants (20 Sibs-autism, of whom six were later diagnosed with autism; 20 Sibs-NA), we tested (a) associations between sensory responsiveness at 12-18 months and communication 9 months later and (b) evaluated whether such associations were moderated by sibling group, autism diagnosis, or age. We found negative zero-order correlations between sensory responsiveness (i.e., caregiver reported hyperresponsiveness and hyporesponsiveness; an observational measure of hyperresponsiveness) and later communication. Additionally, caregiver reported sensory seeking was negatively associated with later expressive communication only in Sibs-NA. Limitations include our relatively small sample size of infants diagnosed with autism. Implications for future research are discussed.
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Affiliation(s)
- Jacob I Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 8310 South Tower, 1215 21St Avenue South, Nashville, TN, 37232, USA.
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA.
| | - Varsha Garla
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Kacie Dunham
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | - Jennifer E Markfeld
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | - Sarah M Bowman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 8310 South Tower, 1215 21St Avenue South, Nashville, TN, 37232, USA
- Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Alexandra J Golden
- Vanderbilt School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Claire Daly
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | - Sophia Kaiser
- Cognitive Studies Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Nisha Mailapur
- Economics Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Sweeya Raj
- Vanderbilt School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Pooja Santapuram
- Vanderbilt School of Medicine, Vanderbilt University, Nashville, TN, USA
- Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Evan Suzman
- Master's Program in Biomedical Science, Vanderbilt University, Nashville, TN, USA
- University of Texas Southwestern Medical School, University of Texas, Dallas, TX, USA
| | - Ashley E Augustine
- Biological Sciences Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- Department of Pediatrics, University Hospitals Cleveland, Cleveland, OH, USA
| | - Aine Muhumuza
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Carissa J Cascio
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kathryn L Williams
- Department of Occupational Therapy and Occupational Science, Towson University, Towson, MD, USA
| | - Anne V Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT, USA
| | - Bahar Keceli-Kaysili
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 8310 South Tower, 1215 21St Avenue South, Nashville, TN, 37232, USA
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 8310 South Tower, 1215 21St Avenue South, Nashville, TN, 37232, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
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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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Dwyer P, Vukusic S, Williams ZJ, Saron CD, Rivera SM. "Neural Noise" in Auditory Responses in Young Autistic and Neurotypical Children. J Autism Dev Disord 2024; 54:642-661. [PMID: 36434480 PMCID: PMC10209352 DOI: 10.1007/s10803-022-05797-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/27/2022]
Abstract
Elevated "neural noise" has been advanced as an explanation of autism and autistic sensory experiences. However, functional neuroimaging measures of neural noise may be vulnerable to contamination by recording noise. This study explored variability of electrophysiological responses to tones of different intensities in 127 autistic and 79 typically-developing children aged 2-5 years old. A rigorous data processing pipeline, including advanced visualizations of different signal sources that were maximally independent across different time lags, was used to identify and eliminate putative recording noise. Inter-trial variability was measured using median absolute deviations (MADs) of EEG amplitudes across trials and inter-trial phase coherence (ITPC). ITPC was elevated in autism in the 50 and 60 dB intensity conditions, suggesting diminished (rather than elevated) neural noise in autism, although reduced ITPC to soft 50 dB sounds was associated with increased loudness discomfort. Autistic and non-autistic participants did not differ in MADs, and indeed, the vast majority of the statistical tests examined in this study yielded no significant effects. These results appear inconsistent with the neural noise account.
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Affiliation(s)
- Patrick Dwyer
- Department of Psychology, UC Davis, Davis, CA, USA.
- Center for Mind and Brain, UC Davis, Davis, CA, USA.
- MIND Institute, UC Davis Health, Sacramento, CA, USA.
| | | | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Clifford D Saron
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis Health, Sacramento, CA, USA
| | - Susan M Rivera
- Department of Psychology, UC Davis, Davis, CA, USA
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis Health, Sacramento, CA, USA
- College of Behavioral and Social Sciences, University of Maryland, College Park, MD, USA
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Neel ML, Jeanvoine A, Key A, Stark AR, Norton ES, Relland LM, Hay K, Maitre NL. Behavioral and neural measures of infant responsivity increase with maternal multisensory input in non-irritable infants. Brain Behav 2023; 13:e3253. [PMID: 37786238 PMCID: PMC10636412 DOI: 10.1002/brb3.3253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023] Open
Abstract
INTRODUCTION Parents often use sensory stimulation during early-life interactions with infants. These interactions, including gazing, rocking, or singing, scaffold child development. Previous studies have examined infant neural processing during highly controlled sensory stimulus presentation paradigms. OBJECTIVE In this study, we investigated infant behavioral and neural responsiveness during a mother-child social interaction during which the mother provided infant stimulation with a progressive increase in the number of sensory modalities. METHODS We prospectively collected and analyzed video-coded behavioral interactions and electroencephalogram (EEG) frontal asymmetry (FAS) from infants (n = 60) at 2-4 months born at ≥ 34 weeks gestation. As the number of sensory modalities progressively increased during the interaction, infant behaviors of emotional connection in facial expressiveness, sensitivity to mother, and vocal communication increased significantly. Conversely, infant FAS for the entire cohort did not change significantly. However, when we accounted for infant irritability, both video-coded behaviors and EEG FAS markers of infant responsiveness increased across the interaction in the non-irritable infants. The non-irritable infants (49%) demonstrated positive FAS, indicating readiness to engage with, rather than to withdraw from, multisensory but not unisensory interactions with their mothers. RESULTS These results suggest that multisensory input from mothers is associated with greater infant neural approach state and highlight the importance of infant behavioral state during neural measures of infant responsiveness.
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Affiliation(s)
- Mary Lauren Neel
- Department of Pediatrics & NeonatologyEmory University School of Medicine & Children's Healthcare of AtlantaAtlanta, GAUSA
| | - Arnaud Jeanvoine
- The Abigail Wexner Research Institute at Nationwide Children's HospitalColumbus, OHUSA
| | | | - Ann R. Stark
- Department of Pediatrics & NeonatologyBeth Israel Deaconess Medical Center & Harvard Medical SchoolBoston, MAUSA
| | | | - Lance M. Relland
- The Abigail Wexner Research Institute at Nationwide Children's HospitalColumbus, OHUSA
- Department of Anesthesiology & Pain MedicineNationwide Children's Hospital & The Ohio State UniversityColumbus, OHUSA
| | - Krystal Hay
- The Abigail Wexner Research Institute at Nationwide Children's HospitalColumbus, OHUSA
| | - Nathalie L. Maitre
- Department of Pediatrics & NeonatologyEmory University School of Medicine & Children's Healthcare of AtlantaAtlanta, GAUSA
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10
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Dwyer P, Williams ZJ, Vukusic S, Saron CD, Rivera SM. Habituation of auditory responses in young autistic and neurotypical children. Autism Res 2023; 16:1903-1923. [PMID: 37688470 PMCID: PMC10651062 DOI: 10.1002/aur.3022] [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: 03/24/2023] [Accepted: 08/16/2023] [Indexed: 09/11/2023]
Abstract
Prior studies suggest that habituation of sensory responses is reduced in autism and that diminished habituation could be related to atypical autistic sensory experiences, for example, by causing brain responses to aversive stimuli to remain strong over time instead of being suppressed. While many prior studies exploring habituation in autism have repeatedly presented identical stimuli, other studies suggest group differences can still be observed in habituation to intermittent stimuli. The present study explored habituation of electrophysiological responses to auditory complex tones of varying intensities (50-80 dB SPL), presented passively in an interleaved manner, in a well-characterized sample of 127 autistic (MDQ = 65.41, SD = 20.54) and 79 typically developing (MDQ = 106.02, SD = 11.50) children between 2 and 5 years old. Habituation was quantified as changes in the amplitudes of single-trial responses to tones of each intensity over the course of the experiment. Habituation of the auditory N2 response was substantially reduced in autistic participants as compared to typically developing controls, although diagnostic groups did not clearly differ in habituation of the P1 response. Interestingly, the P1 habituated less to loud 80 dB sounds than softer sounds, whereas the N2 habituated less to soft 50 dB sounds than louder sounds. No associations were found between electrophysiological habituation and cognitive ability or participants' caregiver-reported sound tolerance (Sensory Profile Hyperacusis Index). The results present study results extend prior research suggesting habituation of certain sensory responses is reduced in autism; however, they also suggest that habituation differences observed using this study's paradigm might not be a primary driver of autistic participants' real-world sound intolerance.
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Affiliation(s)
- Patrick Dwyer
- Department of Psychology, UC Davis, Davis, CA, USA
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis, Davis, CA, USA
| | - Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of
Medicine, Nashville, TN, USA
- Department of Hearing & Speech Sciences, Vanderbilt University
Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN,
USA
- Frist Center for Autism and Innovation, Vanderbilt University,
Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center,
Nashville, TN, USA
| | - Svjetlana Vukusic
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- Department of General Practice, Melbourne Medical School, the
University of Melbourne, Melbourne, VIC, Australia
| | - Clifford D. Saron
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis, Sacramento, CA, USA
| | - Susan M. Rivera
- Department of Psychology, UC Davis, Davis, CA, USA
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis, Sacramento, CA, USA
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Sumathipala SH, Khan S, Kozol RA, Araki Y, Syed S, Huganir RL, Dallman JE. Context-dependent hyperactivity in syngap1a and syngap1b zebrafish autism models. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.20.557316. [PMID: 37786701 PMCID: PMC10541574 DOI: 10.1101/2023.09.20.557316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background and Aims SYNGAP1 disorder is a prevalent genetic form of Autism Spectrum Disorder and Intellectual Disability (ASD/ID) and is caused by de novo or inherited mutations in one copy of the SYNGAP1 gene. In addition to ASD/ID, SYNGAP1 disorder is associated with comorbid symptoms including treatment-resistant-epilepsy, sleep disturbances, and gastrointestinal distress. Mechanistic links between these diverse symptoms and SYNGAP1 variants remain obscure, therefore, our goal was to generate a zebrafish model in which this range of symptoms can be studied. Methods We used CRISPR/Cas9 to introduce frameshift mutations in the syngap1a and syngap1b zebrafish duplicates (syngap1ab) and validated these stable models for Syngap1 loss-of-function. Because SYNGAP1 is extensively spliced, we mapped splice variants to the two zebrafish syngap1a and b genes and identified mammalian-like isoforms. We then quantified locomotory behaviors in zebrafish syngap1ab larvae under three conditions that normally evoke different arousal states in wild type larvae: aversive, high-arousal acoustic, medium-arousal dark, and low-arousal light stimuli. Results We show that CRISPR/Cas9 indels in zebrafish syngap1a and syngap1b produced loss-of-function alleles at RNA and protein levels. Our analyses of zebrafish Syngap1 isoforms showed that, as in mammals, zebrafish Syngap1 N- and C-termini are extensively spliced. We identified a zebrafish syngap1 α1-like variant that maps exclusively to the syngap1b gene. Quantifying locomotor behaviors showed that syngap1ab larvae are hyperactive compared to wild type but to differing degrees depending on the stimulus. Hyperactivity was most pronounced in low arousal settings, with overall movement increasing with the number of mutant syngap1 alleles. Conclusions Our data support mutations in zebrafish syngap1ab as causal for hyperactivity associated with elevated arousal that is especially pronounced in low-arousal environments.
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Affiliation(s)
- Sureni H. Sumathipala
- Department of Biology, University of Miami, Coral Gables, FL USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Suha Khan
- Department of Biology, University of Miami, Coral Gables, FL USA
| | - Robert A. Kozol
- Department of Biology, University of Miami, Coral Gables, FL USA
- Jupiter Life Science Initiative, Florida Atlantic University, Jupiter FL, USA
| | - Yoichi Araki
- Department of Neuroscience and Kavli Neuroscience Discovery Institute, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Sheyum Syed
- Department of Physics, University of Miami, Coral Gables, FL USA
| | - Richard L. Huganir
- Department of Neuroscience and Kavli Neuroscience Discovery Institute, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Julia E. Dallman
- Department of Biology, University of Miami, Coral Gables, FL USA
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12
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Williams ZJ, Schaaf R, Ausderau KK, Baranek GT, Barrett DJ, Cascio CJ, Dumont RL, Eyoh EE, Failla MD, Feldman JI, Foss-Feig JH, Green HL, Green SA, He JL, Kaplan-Kahn EA, Keçeli-Kaysılı B, MacLennan K, Mailloux Z, Marco EJ, Mash LE, McKernan EP, Molholm S, Mostofsky SH, Puts NAJ, Robertson CE, Russo N, Shea N, Sideris J, Sutcliffe JS, Tavassoli T, Wallace MT, Wodka EL, Woynaroski TG. Examining the latent structure and correlates of sensory reactivity in autism: a multi-site integrative data analysis by the autism sensory research consortium. Mol Autism 2023; 14:31. [PMID: 37635263 PMCID: PMC10464466 DOI: 10.1186/s13229-023-00563-4] [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: 01/05/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population. METHODS Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO, and SEEK (sub)constructs. RESULTS All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses supported the validity of a supra-modal HYPER construct (ωH = .800) but not a supra-modal HYPO construct (ωH = .653), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ωH = .800; 4/7 modalities). Modality-specific subscales demonstrated significant added value for all response patterns. Meta-analytic correlations varied by construct, although sensory features tended to correlate most with other domains of core autism features and co-occurring psychiatric symptoms (with general HYPER and speech HYPO demonstrating the largest numbers of practically significant correlations). LIMITATIONS Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to caregiver report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences. CONCLUSION Of the three sensory response patterns, only HYPER demonstrated sufficient evidence for valid interpretation at the supra-modal level, whereas supra-modal HYPO/SEEK constructs demonstrated substantial psychometric limitations. For clinicians and researchers seeking to characterize sensory reactivity in autism, modality-specific response pattern scores may represent viable alternatives that overcome many of these limitations.
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Affiliation(s)
- Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA.
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA.
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA.
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Roseann Schaaf
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
- Jefferson Autism Center of Excellence, Farber Institute of Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA
| | - Karla K Ausderau
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Grace T Baranek
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - D Jonah Barrett
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Carissa J Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachel L Dumont
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ekomobong E Eyoh
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | | | - Jacob I Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - Jennifer H Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Heather L Green
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shulamite A Green
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, USA
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Elizabeth A Kaplan-Kahn
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bahar Keçeli-Kaysılı
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
| | - Keren MacLennan
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Department of Psychology, Durham University, Durham, UK
| | - Zoe Mailloux
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Elysa J Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, CA, USA
| | - Lisa E Mash
- Division of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Elizabeth P McKernan
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sophie Molholm
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
- Dominick P. Purpura Department of Neuroscience, Rose F. Kennedy Intellectual and Developmental Disabilities Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicolaas A J Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Caroline E Robertson
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Natalie Russo
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Nicole Shea
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Division of Pulmonology and Sleep Medicine, Department of Pediatrics, Kaleida Health, Buffalo, NY, USA
| | - John Sideris
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - James S Sutcliffe
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Teresa Tavassoli
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Mark T Wallace
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Ericka L Wodka
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
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13
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Lau BK, Emmons KA, Lee AKC, Munson J, Dager SR, Estes AM. The prevalence and developmental course of auditory processing differences in autistic children. Autism Res 2023. [PMID: 37376987 DOI: 10.1002/aur.2961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/19/2023] [Indexed: 06/29/2023]
Abstract
Auditory processing differences, including hyper- or hyposensitivity to sound, aversions to sound, and difficulty listening under noisy, real-world conditions, are commonly reported in autistic individuals. However, the developmental course and functional impact of these auditory processing differences are unclear. In this study, we investigate the prevalence, developmental trajectory, and functional impact of auditory processing differences in autistic children throughout childhood using a longitudinal study design. Auditory processing differences were measured using the Short Sensory Profile, a caregiver questionnaire, in addition to adaptive behaviors and disruptive/concerning behaviors at 3, 6, and 9 years of age. Our results showed that auditory processing differences were reported in greater than 70% of the autistic children in our sample at all three timepoints, maintained a high prevalence through 9 years of age, and were associated with increased disruptive/concerning behaviors and difficulty with adaptive behaviors. Furthermore, in our sample of children, auditory processing differences at age 3 years predicted disruptive/concerning behaviors and difficulty with adaptive behaviors at age 9 years. These findings warrant further investigations of the potential benefit of incorporating measures of auditory processing during routine clinical evaluations as well as interventions targeting auditory processing differences in autistic children.
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Affiliation(s)
- Bonnie K Lau
- Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | | | - Adrian K C Lee
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
- Institute for Learning and Brain Sciences, University of Washington, Seattle, WA, USA
| | - Jeff Munson
- Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Annette M Estes
- UW Autism Center, University of Washington, Seattle, WA, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
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14
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Kyriacou C, Forrester-Jones R, Triantafyllopoulou P. Clothes, Sensory Experiences and Autism: Is Wearing the Right Fabric Important? J Autism Dev Disord 2023. [PMID: 34287735 DOI: 10.1007/s10803-021-05140-] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Tactile defensiveness in autistic individuals is the least investigated sensory modality. The current multi-component, explorative study aimed to understand the experiences of ten autistic adults regarding tactile defensiveness and fabrics, using semi-structured, one-to-one interviews. Participants were asked to discuss the effects of seven provided samples of fabrics and were also asked to bring their 'favourite' fabric (s) and express their thoughts about their choices. Using Interpretative Phenomenological Analysis and Content Analysis, the findings showed that some fabrics can impact individuals' reported wellbeing. Participants' experiences with several stimuli appeared to have helped them implement coping strategies. By understanding tactile defensiveness, society could move towards increasing autism-friendly approaches with appropriate fabrics. Recommendations for future research, policy and practice are also discussed.
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Affiliation(s)
- Chrysovalanto Kyriacou
- Tizard Centre, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, Kent, UK
| | - Rachel Forrester-Jones
- Department of Social and Policy Sciences, Centre of Analysis of Social Policy, University of Bath, Bath, UK
| | - Paraskevi Triantafyllopoulou
- Tizard Centre, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, Kent, UK.
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15
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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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16
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Alhassan S, Soudani A, Almusallam M. Energy-Efficient EEG-Based Scheme for Autism Spectrum Disorder Detection Using Wearable Sensors. SENSORS (BASEL, SWITZERLAND) 2023; 23:2228. [PMID: 36850829 PMCID: PMC9962521 DOI: 10.3390/s23042228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 06/15/2023]
Abstract
The deployment of wearable wireless systems that collect physiological indicators to aid in diagnosing neurological disorders represents a potential solution for the new generation of e-health systems. Electroencephalography (EEG), a recording of the brain's electrical activity, is a promising physiological test for the diagnosis of autism spectrum disorders. It can identify the abnormalities of the neural system that are associated with autism spectrum disorders. However, streaming EEG samples remotely for classification can reduce the wireless sensor's lifespan and creates doubt regarding the application's feasibility. Therefore, decreasing data transmission may conserve sensor energy and extend the lifespan of wireless sensor networks. This paper suggests the development of a sensor-based scheme for early age autism detection. The proposed scheme implements an energy-efficient method for signal transformation allowing relevant feature extraction for accurate classification using machine learning algorithms. The experimental results indicate an accuracy of 96%, a sensitivity of 100%, and around 95% of F1 score for all used machine learning models. The results also show that our scheme energy consumption is 97% lower than streaming the raw EEG samples.
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Affiliation(s)
- Sarah Alhassan
- Department of Computer Science, College of Computer and Information Science, King Saud University, Riyadh 11362, Saudi Arabia
- Department of Computer Science, College of Computer and Information Science, Imam Mohammad Ibn Saud Islamic University, Riyadh 11564, Saudi Arabia
| | - Adel Soudani
- Department of Computer Science, College of Computer and Information Science, King Saud University, Riyadh 11362, Saudi Arabia
| | - Manan Almusallam
- Department of Computer Science, College of Computer and Information Science, Imam Mohammad Ibn Saud Islamic University, Riyadh 11564, Saudi Arabia
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17
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Sensory Processing and Autistic Traits: Mediation Effect of Frontal Alpha Asymmetry. Occup Ther Int 2023; 2023:5065120. [PMID: 36721758 PMCID: PMC9884162 DOI: 10.1155/2023/5065120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 12/30/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
A sensory processing approach can be used to intervene with behaviours in individuals with autistic symptoms. However, neural mechanisms linking sensory processing patterns and autistic features are less understood. The purpose of this study was to investigate whether frontal alpha asymmetry could mediate the relationship between atypical sensory processing and autistic traits. Seventy-three neurotypical young adults were included in this study. Resting-state brain activity was recorded using electroencephalography. After the recording, participants completed the Adolescent/Adult Sensory Profile and the Autism-Spectrum Quotient. Frontal alpha asymmetry was calculated by subtracting left frontal alpha power from right frontal alpha power. Correlation analysis was performed to find which sensory processing patterns were related to frontal alpha asymmetry and autistic traits. Mediation analysis was then conducted with sensory avoiding patterns as an independent variable, autistic traits as a dependent variable, and frontal alpha asymmetry as a mediator. Interrelations between higher sensation avoiding patterns, greater right-sided cortical activity, and increased autistic traits were found. The sensation avoiding patterns affected autistic traits directly and indirectly through right-sided cortical activity. Findings of the current study demonstrate a mediating role of frontal alpha asymmetry in the relationship between sensation avoiding patterns and autistic traits in neurotypical adults. This study suggests that sensation avoiding patterns and withdrawal-related emotions, which are associated with right-sided cortical activity, need to be considered to improve autism symptoms.
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18
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Williams ZJ, Schaaf R, Ausderau KK, Baranek GT, Barrett DJ, Cascio CJ, Dumont RL, Eyoh EE, Failla MD, Feldman JI, Foss-Feig JH, Green HL, Green SA, He JL, Kaplan-Kahn EA, Keçeli-Kaysılı B, MacLennan K, Mailloux Z, Marco EJ, Mash LE, McKernan EP, Molholm S, Mostofsky SH, Puts NAJ, Robertson CE, Russo N, Shea N, Sideris J, Sutcliffe JS, Tavassoli T, Wallace MT, Wodka EL, Woynaroski TG. Examining the Latent Structure and Correlates of Sensory Reactivity in Autism: A Multi-site Integrative Data Analysis by the Autism Sensory Research Consortium. RESEARCH SQUARE 2023:rs.3.rs-2447849. [PMID: 36712092 PMCID: PMC9882639 DOI: 10.21203/rs.3.rs-2447849/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population. Methods Leveraging a combined sample of 3,868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO and SEEK (sub)constructs. Results All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses unambiguously supported the validity of a supra-modal HYPER construct (ω H = .800), whereas a coherent supra-modal HYPO construct was not supported (ω H = .611), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ω H = .799; 4/7 modalities). Within each sensory construct, modality-specific subscales demonstrated substantial added value beyond the supra-modal score. Meta-analytic correlations varied by construct, although sensory features tended to correlate most strongly with other domains of core autism features and co-occurring psychiatric symptoms. Certain subconstructs within the HYPO and SEEK domains were also associated with lower adaptive behavior scores. Limitations: Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to parent-report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences. Conclusion Psychometric issues may limit the degree to which some measures of supra-modal HYPO/SEEK can be interpreted. Depending on the research question at hand, modality-specific response pattern scores may represent a valid alternative method of characterizing sensory reactivity in autism.
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19
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Dwyer P, Takarae Y, Zadeh I, Rivera SM, Saron CD. A Multidimensional Investigation of Sensory Processing in Autism: Parent- and Self-Report Questionnaires, Psychophysical Thresholds, and Event-Related Potentials in the Auditory and Somatosensory Modalities. Front Hum Neurosci 2022; 16:811547. [PMID: 35620155 PMCID: PMC9127065 DOI: 10.3389/fnhum.2022.811547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Reconciling results obtained using different types of sensory measures is a challenge for autism sensory research. The present study used questionnaire, psychophysical, and neurophysiological measures to characterize autistic sensory processing in different measurement modalities. Methods Participants were 46 autistic and 21 typically developing 11- to 14-year-olds. Participants and their caregivers completed questionnaires regarding sensory experiences and behaviors. Auditory and somatosensory event-related potentials (ERPs) were recorded as part of a multisensory ERP task. Auditory detection, tactile static detection, and tactile spatial resolution psychophysical thresholds were measured. Results Sensory questionnaires strongly differentiated between autistic and typically developing individuals, while little evidence of group differences was observed in psychophysical thresholds. Crucially, the different types of measures (neurophysiological, psychophysical, questionnaire) appeared to be largely independent of one another. However, we unexpectedly found autistic participants with larger auditory Tb ERP amplitudes had reduced hearing acuity, even though all participants had hearing acuity in the non-clinical range. Limitations The autistic and typically developing groups were not matched on cognitive ability, although this limitation does not affect our main analyses regarding convergence of measures within autism. Conclusion Overall, based on these results, measures in different sensory modalities appear to capture distinct aspects of sensory processing in autism, with relatively limited convergence between questionnaires and laboratory-based tasks. Generally, this might reflect the reality that laboratory tasks are often carried out in controlled environments without background stimuli to compete for attention, a context which may not closely resemble the busier and more complex environments in which autistic people's atypical sensory experiences commonly occur. Sensory questionnaires and more naturalistic laboratory tasks may be better suited to explore autistic people's real-world sensory challenges. Further research is needed to replicate and investigate the drivers of the unexpected association we observed between auditory Tb ERP amplitudes and hearing acuity, which could represent an important confound for ERP researchers to consider in their studies.
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Affiliation(s)
- Patrick Dwyer
- Neurocognitive Development Lab, Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
- MIND Institute, University of California, Davis, Davis, CA, United States
| | - Yukari Takarae
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Iman Zadeh
- Oracle Cloud Infrastructure, Oracle Corporation, Los Angeles, CA, United States
| | - Susan M. Rivera
- Neurocognitive Development Lab, Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
- MIND Institute, University of California, Davis, Davis, CA, United States
| | - Clifford D. Saron
- MIND Institute, University of California, Davis, Davis, CA, United States
- Saron Lab, Center for Mind and Brain, University of California, Davis, Davis, CA, United States
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20
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Ayoub MJ, Keegan L, Tager-Flusberg H, Gill SV. Neuroimaging Techniques as Descriptive and Diagnostic Tools for Infants at Risk for Autism Spectrum Disorder: A Systematic Review. Brain Sci 2022; 12:602. [PMID: 35624989 PMCID: PMC9139416 DOI: 10.3390/brainsci12050602] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Autism Spectrum Disorder (ASD) has traditionally been evaluated and diagnosed via behavioral assessments. However, increasing research suggests that neuroimaging as early as infancy can reliably identify structural and functional differences between autistic and non-autistic brains. The current review provides a systematic overview of imaging approaches used to identify differences between infants at familial risk and without risk and predictive biomarkers. Two primary themes emerged after reviewing the literature: (1) neuroimaging methods can be used to describe structural and functional differences between infants at risk and infants not at risk for ASD (descriptive), and (2) neuroimaging approaches can be used to predict ASD diagnosis among high-risk infants and developmental outcomes beyond infancy (predicting later diagnosis). Combined, the articles highlighted that several neuroimaging studies have identified a variety of neuroanatomical and neurological differences between infants at high and low risk for ASD, and among those who later receive an ASD diagnosis. Incorporating neuroimaging into ASD evaluations alongside traditional behavioral assessments can provide individuals with earlier diagnosis and earlier access to supportive resources.
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Affiliation(s)
- Maria J. Ayoub
- College of Health and Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA; (M.J.A.); (L.K.)
| | - Laura Keegan
- College of Health and Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA; (M.J.A.); (L.K.)
| | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA;
| | - Simone V. Gill
- College of Health and Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA; (M.J.A.); (L.K.)
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21
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Zengin G, Huri M. The sensory processing patterns of individuals with schizophrenia with comorbid substance use disorder. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2071348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Gülşah Zengin
- Therapy and Rehabilitation Department, Nevşehir Hacı Bektaş Veli University, Nevşehir, Turkey
| | - Meral Huri
- Occupational Therapy Department, Hacettepe University, Ankara, Turkey
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22
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Wen TH, Cheng A, Andreason C, Zahiri J, Xiao Y, Xu R, Bao B, Courchesne E, Barnes CC, Arias SJ, Pierce K. Large scale validation of an early-age eye-tracking biomarker of an autism spectrum disorder subtype. Sci Rep 2022; 12:4253. [PMID: 35277549 PMCID: PMC8917231 DOI: 10.1038/s41598-022-08102-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/28/2022] [Indexed: 01/07/2023] Open
Abstract
Few clinically validated biomarkers of ASD exist which can rapidly, accurately, and objectively identify autism during the first years of life and be used to support optimized treatment outcomes and advances in precision medicine. As such, the goal of the present study was to leverage both simple and computationally-advanced approaches to validate an eye-tracking measure of social attention preference, the GeoPref Test, among 1,863 ASD, delayed, or typical toddlers (12-48 months) referred from the community or general population via a primary care universal screening program. Toddlers participated in diagnostic and psychometric evaluations and the GeoPref Test: a 1-min movie containing side-by-side dynamic social and geometric images. Following testing, diagnosis was denoted as ASD, ASD features, LD, GDD, Other, typical sibling of ASD proband, or typical. Relative to other diagnostic groups, ASD toddlers exhibited the highest levels of visual attention towards geometric images and those with especially high fixation levels exhibited poor clinical profiles. Using the 69% fixation threshold, the GeoPref Test had 98% specificity, 17% sensitivity, 81% PPV, and 65% NPV. Sensitivity increased to 33% when saccades were included, with comparable validity across sex, ethnicity, or race. The GeoPref Test was also highly reliable up to 24 months following the initial test. Finally, fixation levels among twins concordant for ASD were significantly correlated, indicating that GeoPref Test performance may be genetically driven. As the GeoPref Test yields few false positives (~ 2%) and is equally valid across demographic categories, the current findings highlight the ability of the GeoPref Test to rapidly and accurately detect autism before the 2nd birthday in a subset of children and serve as a biomarker for a unique ASD subtype in clinical trials.
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Affiliation(s)
- Teresa H Wen
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA.
| | - Amanda Cheng
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Charlene Andreason
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Javad Zahiri
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Yaqiong Xiao
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Ronghui Xu
- Herbert Wertheim School of Public Health and Department of Mathematics, University of California, San Diego, La Jolla, CA, USA
| | - Bokan Bao
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
- Department of Bioinformatics and Systems Biology, University of California, San Diego, La Jolla, CA, USA
| | - Eric Courchesne
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Cynthia Carter Barnes
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Steven J Arias
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Karen Pierce
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA.
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23
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Chen YJ, Sideris J, Watson LR, Crais ER, Baranek GT. Developmental trajectories of sensory patterns from infancy to school age in a community sample and associations with autistic traits. Child Dev 2022; 93:e446-e459. [PMID: 35238019 DOI: 10.1111/cdev.13745] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This prospective study examined the latent growth trajectories of sensory patterns among a North Carolina birth cohort (N = 1517; 49% boys, 87% White) across infancy (6-19 months), preschool (3-4 years), and school years (6-7 years). Change rates of sensory hyper- and hyporesponsiveness better differentiated children with an autism diagnosis or elevated autistic traits from those with other developmental conditions, including non-autistic children with sensory differences. More sensory hyper- and hyporesponsiveness at infancy followed by steeper increases differentially predicted more autistic traits at school age. Further, children of parents with higher education tended to show stable or improving trajectories. These findings highlight the importance of tracking sensory patterns from infancy for facilitating early identification of associated challenges and tailored support for families.
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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, California, USA
| | - John Sideris
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Linda R Watson
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth R Crais
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Grace T Baranek
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
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24
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Clairmont C, Wang J, Tariq S, Sherman HT, Zhao M, Kong XJ. The Value of Brain Imaging and Electrophysiological Testing for Early Screening of Autism Spectrum Disorder: A Systematic Review. Front Neurosci 2022; 15:812946. [PMID: 35185452 PMCID: PMC8851356 DOI: 10.3389/fnins.2021.812946] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Given the significance of validating reliable tests for the early detection of autism spectrum disorder (ASD), this systematic review aims to summarize available evidence of neuroimaging and neurophysiological changes in high-risk infants to improve ASD early diagnosis. We included peer-reviewed, primary research in English published before May 21, 2021, involving the use of magnetic resonance imaging (MRI), electroencephalogram (EEG), or functional near-infrared spectroscopy (fNIRS) in children with high risk for ASD under 24 months of age. The main exclusion criteria includes diagnosis of a genetic disorder and gestation age of less the 36 weeks. Online research was performed on PubMed, Web of Science, PsycINFO, and CINAHL. Article selection was conducted by two reviewers to minimize bias. This research was funded by Massachusetts General Hospital Sundry funding. IRB approval was not submitted as it was deemed unnecessary. We included 75 primary research articles. Studies showed that high-risk infants had divergent developmental trajectories for fractional anisotropy and regional brain volumes, increased CSF volume, and global connectivity abnormalities on MRI, decreased sensitivity for familiar faces, atypical lateralization during facial and auditory processing, and different spectral powers across multiple band frequencies on EEG, and distinct developmental trajectories in functional connectivity and regional oxyhemoglobin concentrations in fNIRS. These findings in infants were found to be correlated with the core ASD symptoms and diagnosis at toddler age. Despite the lack of quantitative analysis of the research database, neuroimaging and electrophysiological biomarkers have promising value for the screening of ASD as early as infancy with high accuracy, which warrants further investigation.
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Affiliation(s)
- Cullen Clairmont
- Synapse Lab, Athinoula A. Martinos Center, Massachusetts General Hospital, Boston, MA, United States
| | - Jiuju Wang
- Synapse Lab, Athinoula A. Martinos Center, Massachusetts General Hospital, Boston, MA, United States
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China
| | - Samia Tariq
- Synapse Lab, Athinoula A. Martinos Center, Massachusetts General Hospital, Boston, MA, United States
| | - Hannah Tayla Sherman
- Synapse Lab, Athinoula A. Martinos Center, Massachusetts General Hospital, Boston, MA, United States
| | - Mingxuan Zhao
- Department of Business Analytics, Bentley University, Waltham, MA, United States
| | - Xue-Jun Kong
- Synapse Lab, Athinoula A. Martinos Center, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
- *Correspondence: Xue-Jun Kong,
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25
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Kirby AV, Bilder DA, Wiggins LD, Hughes MM, Davis J, Hall-Lande JA, Lee LC, McMahon WM, Bakian AV. Sensory features in autism: Findings from a large population-based surveillance system. Autism Res 2022; 15:751-760. [PMID: 35040592 PMCID: PMC9067163 DOI: 10.1002/aur.2670] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/12/2021] [Accepted: 12/16/2021] [Indexed: 12/29/2022]
Abstract
Sensory features (i.e., atypical responses to sensory stimuli) are included in the current diagnostic criteria for autism spectrum disorder. Yet, large population‐based studies have not examined these features. This study aimed to determine the prevalence of sensory features among autistic children, and examine associations between sensory features, demographics, and co‐occurring problems in other areas. Analysis for this study included a sample comprised of 25,627 four‐ or eight‐year‐old autistic children identified through the multistate Autism and Developmental Disabilities Monitoring Network (2006–2014). We calculated the prevalence of sensory features and applied multilevel logistic regression modeling. The majority (74%; 95% confidence interval: 73.5%–74.5%) of the children studied had documented sensory features. In a multivariable model, children who were male and those whose mothers had more years of education had higher odds of documented sensory features. Children from several racial and ethnic minority groups had lower odds of documented sensory features than White, non‐Hispanic children. Cognitive problems were not significantly related to sensory features. Problems related to adaptive behavior, emotional states, aggression, attention, fear, motor development, eating, and sleeping were associated with higher odds of having documented sensory features. Results from a large, population‐based sample indicate a high prevalence of sensory features in autistic children, as well as relationships between sensory features and co‐occurring problems. This study also pointed to potential disparities in the identification of sensory features, which should be examined in future research. Disparities should also be considered clinically to avoid reduced access to supports for sensory features and related functional problems.
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Affiliation(s)
- Anne V Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA.,Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Deborah A Bilder
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michelle M Hughes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John Davis
- Department of Educational Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Jennifer A Hall-Lande
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - William M McMahon
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Amanda V Bakian
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
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26
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Park S, Haak KV, Cho HB, Valk SL, Bethlehem RAI, Milham MP, Bernhardt BC, Di Martino A, Hong SJ. Atypical Integration of Sensory-to-Transmodal Functional Systems Mediates Symptom Severity in Autism. Front Psychiatry 2021; 12:699813. [PMID: 34489757 PMCID: PMC8417581 DOI: 10.3389/fpsyt.2021.699813] [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: 04/24/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
A notable characteristic of autism spectrum disorder (ASD) is co-occurring deficits in low-level sensory processing and high-order social interaction. While there is evidence indicating detrimental cascading effects of sensory anomalies on the high-order cognitive functions in ASD, the exact pathological mechanism underlying their atypical functional interaction across the cortical hierarchy has not been systematically investigated. To address this gap, here we assessed the functional organisation of sensory and motor areas in ASD, and their relationship with subcortical and high-order trandmodal systems. In a resting-state fMRI data of 107 ASD and 113 neurotypical individuals, we applied advanced connectopic mapping to probe functional organization of primary sensory/motor areas, together with targeted seed-based intrinsic functional connectivity (iFC) analyses. In ASD, the connectopic mapping revealed topological anomalies (i.e., excessively more segregated iFC) in the motor and visual areas, the former of which patterns showed association with the symptom severity of restricted and repetitive behaviors. Moreover, the seed-based analysis found diverging patterns of ASD-related connectopathies: decreased iFCs within the sensory/motor areas but increased iFCs between sensory and subcortical structures. While decreased iFCs were also found within the higher-order functional systems, the overall proportion of this anomaly tends to increase along the level of cortical hierarchy, suggesting more dysconnectivity in the higher-order functional networks. Finally, we demonstrated that the association between low-level sensory/motor iFCs and clinical symptoms in ASD was mediated by the high-order transmodal systems, suggesting pathogenic functional interactions along the cortical hierarchy. Findings were largely replicated in the independent dataset. These results highlight that atypical integration of sensory-to-high-order systems contributes to the complex ASD symptomatology.
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Affiliation(s)
- Shinwon Park
- Institute for Basic Science, Center for Neuroscience Imaging Research, Sungkyunkwan University, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Koen V. Haak
- Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Han Byul Cho
- Institute for Basic Science, Center for Neuroscience Imaging Research, Sungkyunkwan University, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Sofie L. Valk
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7), Forschungszentrum Jülich, Jülich, Germany
| | - Richard A. I. Bethlehem
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, United Kingdom
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Michael P. Milham
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States
- Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute, New York, NY, United States
| | - Boris C. Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | | | - Seok-Jun Hong
- Institute for Basic Science, Center for Neuroscience Imaging Research, Sungkyunkwan University, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States
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27
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Kyriacou C, Forrester-Jones R, Triantafyllopoulou P. Clothes, Sensory Experiences and Autism: Is Wearing the Right Fabric Important? J Autism Dev Disord 2021; 53:1495-1508. [PMID: 34287735 PMCID: PMC10066095 DOI: 10.1007/s10803-021-05140-3] [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: 05/07/2021] [Indexed: 10/20/2022]
Abstract
Tactile defensiveness in autistic individuals is the least investigated sensory modality. The current multi-component, explorative study aimed to understand the experiences of ten autistic adults regarding tactile defensiveness and fabrics, using semi-structured, one-to-one interviews. Participants were asked to discuss the effects of seven provided samples of fabrics and were also asked to bring their 'favourite' fabric (s) and express their thoughts about their choices. Using Interpretative Phenomenological Analysis and Content Analysis, the findings showed that some fabrics can impact individuals' reported wellbeing. Participants' experiences with several stimuli appeared to have helped them implement coping strategies. By understanding tactile defensiveness, society could move towards increasing autism-friendly approaches with appropriate fabrics. Recommendations for future research, policy and practice are also discussed.
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Affiliation(s)
- Chrysovalanto Kyriacou
- Tizard Centre, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, Kent, UK
| | - Rachel Forrester-Jones
- Department of Social and Policy Sciences, Centre of Analysis of Social Policy, University of Bath, Bath, UK
| | - Paraskevi Triantafyllopoulou
- Tizard Centre, School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, Kent, UK.
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28
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Feldman JI, Conrad JG, Kuang W, Tu A, Liu Y, Simon DM, Wallace MT, Woynaroski TG. Relations Between the McGurk Effect, Social and Communication Skill, and Autistic Features in Children with and without Autism. J Autism Dev Disord 2021; 52:1920-1928. [PMID: 34101080 PMCID: PMC8842559 DOI: 10.1007/s10803-021-05074-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 12/20/2022]
Abstract
Children with autism show alterations in multisensory integration that have been theoretically and empirically linked with the core and related features of autism. It is unclear, however, to what extent multisensory integration maps onto features of autism within children with and without autism. This study, thus, evaluates relations between audiovisual integration and core and related autism features across children with and without autism. Thirty-six children reported perceptions of the McGurk illusion during a psychophysical task. Parents reported on participants' autistic features. Increased report of illusory percepts tended to covary with reduced autistic features and greater communication skill. Some relations, though, were moderated by group. This work suggests that associations between multisensory integration and higher-order skills are present, but in some instances vary according to diagnostic group.
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Affiliation(s)
- Jacob I Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University, MCE 8310 South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA.
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA.
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Julie G Conrad
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- College of Medicine, University of Illinois, Chicago, IL, USA
| | - Wayne Kuang
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Alexander Tu
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yupeng Liu
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - David M Simon
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Mark T Wallace
- Department of Hearing and Speech Sciences, Vanderbilt University, MCE 8310 South Tower, 1215 21st Avenue South, Nashville, TN, 37232, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Tiffany G Woynaroski
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
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29
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Feldman JI, Raj S, Bowman SM, Santapuram P, Golden AJ, Daly C, Dunham K, Suzman E, Augustine AE, Garla V, Muhumuza A, Cascio CJ, Williams KL, Kirby AV, Keceli-Kaysili B, Woynaroski TG. Sensory Responsiveness Is Linked With Communication in Infant Siblings of Children With and Without Autism. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1964-1976. [PMID: 34003699 PMCID: PMC8740754 DOI: 10.1044/2021_jslhr-20-00196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/09/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
Purpose Differences in communication development impact long-term outcomes of children with autism. Previous research has identified factors associated with communication in children with autism, but much of the variance in communication skill remains unexplained. It has been proposed that early differences in sensory responsiveness (i.e., hyporesponsiveness, hyperresponsiveness, and sensory seeking) may produce "cascading effects" on communication. Evidence for this theory is limited, however, as relations between sensory responsiveness and communication in the earliest stages of development have not been well established. The purpose of this study was to evaluate (a) whether infants with a heightened likelihood of autism diagnosis (i.e., infants with an older sibling with autism) differ from infants at general population-level likelihood of autism (i.e., infants with an older, nonautistic sibling) on patterns of sensory responsiveness, (b) whether early sensory responsiveness is correlated with concurrent communication, and (c) whether the aforementioned between-groups differences and associations are moderated by age. Method Participants were 40 infants (20 infants with an older sibling with autism, 20 infants with an older, nonautistic sibling) aged 12-18 months. A series of observational and parent report measures of sensory responsiveness and communication skill were administered. Results Group differences in sensory responsiveness across the 12- to 18-month period were limited (i.e., only observed for one measure of hyporesponsiveness), though selected differences in sensory responsiveness (i.e., parent-reported hyperresponsiveness and sensory seeking) emerged between groups over this developmental window. Parent-reported hyporesponsiveness was unconditionally, negatively associated with communication skills. Associations between expressive communication and (a) parent-reported sensory seeking and (b) an observational measure of hyperresponsiveness were moderated by age. Conclusions This study provides new insights into the nature of sensory responsiveness and theorized links with communication skill in infants at elevated and general population-level likelihood of autism diagnosis. Further work is needed to better characterize the effects of interest in a larger sample spanning a wider age range. Supplemental Material https://doi.org/10.23641/asha.14515542.
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Affiliation(s)
- Jacob I. Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Sweeya Raj
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN
| | - Sarah M. Bowman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Pooja Santapuram
- Vanderbilt School of Medicine, Vanderbilt University, Nashville, TN
| | | | - Claire Daly
- Psychology Undergraduate Program, Vanderbilt University, Nashville, TN
| | - Kacie Dunham
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
- Neuroscience Graduate Program, Vanderbilt University, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
| | - Evan Suzman
- Master's Program in Biomedical Sciences, Vanderbilt University, Nashville, TN
| | - Ashley E. Augustine
- Biological Sciences Undergraduate Program, Vanderbilt University, Nashville, TN
| | - Varsha Garla
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN
| | - Aine Muhumuza
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN
| | - Carissa J. Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN
- The First Center for Autism and Innovation, Vanderbilt University, Nashville, TN
| | - Kathryn L. Williams
- Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel Hill
| | - Anne V. Kirby
- Department of Occupational and Recreational Therapies, The University of Utah, Salt Lake City
| | - Bahar Keceli-Kaysili
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN
- The First Center for Autism and Innovation, Vanderbilt University, Nashville, TN
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30
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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.
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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.
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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.
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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.
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Dellapiazza F, Michelon C, Vernhet C, Muratori F, Blanc N, Picot MC, Baghdadli A. Sensory processing related to attention in children with ASD, ADHD, or typical development: results from the ELENA cohort. Eur Child Adolesc Psychiatry 2021; 30:283-291. [PMID: 32215734 DOI: 10.1007/s00787-020-01516-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/16/2020] [Indexed: 01/02/2023]
Abstract
Autism-spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are early neurodevelopmental conditions that share clinical characteristics, raising important issues in clinical diagnosis. We aimed to compare (1) sensory processing in four groups of children: ASD alone, ASD + ADHD, ADHD alone, and typical development (TD) and (2) the association between sensory processing and attention in the three groups with neurodevelopmental disorders. Our sample included 120 children aged from 6 to 12 years divided into four groups: ASD alone (N = 43), ASD + ADHD (N = 18), ADHD alone (N = 28), and TD (N = 31). Atypical sensory processing was more frequent in ASD and/or ADHD than in TD, without a significant difference between ASD and ADHD. However, the variance analysis of attention problems revealed differences between the ADHD and ASD groups. Thus, the rate of atypical sensory processing was comparable between the ASD and ADHD groups, suggesting that further studies are needed to explore atypical SP in all neurodevelopmental disorders.
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Affiliation(s)
- Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France.,Centre de Recherche en Épidémiologie Et Santé Des Populations, U1178, INSERM, Paris, France.,Université Paul Valéry Montpellier 3, Université Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France
| | - Christelle Vernhet
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France.,Centre de Recherche en Épidémiologie Et Santé Des Populations, U1178, INSERM, Paris, France.,Université Paul Valéry Montpellier 3, Université Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | - Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Nathalie Blanc
- Université Paul Valéry Montpellier 3, Université Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | | | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU montpellier, 34000, Montpellier, France. .,Centre de Recherche en Épidémiologie Et Santé Des Populations, U1178, INSERM, Paris, France. .,School of Medicine, Montpellier University, Montpellier, France.
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Grzadzinski R, Donovan K, Truong K, Nowell S, Lee H, Sideris J, Turner-Brown L, Baranek GT, Watson LR. Sensory Reactivity at 1 and 2 Years Old is Associated with ASD Severity During the Preschool Years. J Autism Dev Disord 2021; 50:3895-3904. [PMID: 32157566 DOI: 10.1007/s10803-020-04432-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Children with Autism Spectrum Disorder (ASD) often display atypical sensory reactivity within the first years of life, prior to a diagnosis. This study examined sensory reactivity patterns at 14 months, changes from 14 to 23 months, and later ASD severity at 3 to 5 years of age in children (n = 87) at elevated likelihood of ASD. Results indicated that observed hyporeactivity at 14 months and increases from 14 to 23 months were related to higher ASD severity during the preschool years. Parent report of hyperreactivity at 14 months was associated with higher ASD severity in the RRB domain during the preschool years. Early hypo and hyperreactivity may predict later severity of ASD and aid in subtyping and developing individualized treatments.
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Affiliation(s)
- Rebecca Grzadzinski
- University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC, USA.
| | - Kevin Donovan
- University of North Carolina, Department of Biostatistics, Chapel Hill, NC, USA
| | - Kinh Truong
- University of North Carolina, Department of Biostatistics, Chapel Hill, NC, USA
| | - Sallie Nowell
- University of North Carolina, Frank Porter Graham Child Development Institute, Chapel Hill, NC, USA
| | - Helen Lee
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - John Sideris
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | | | - Grace T Baranek
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Linda R Watson
- University of North Carolina, Division of Speech and Hearing Sciences, Chapel Hill, NC, USA
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Pierce S, Kadlaskar G, Edmondson DA, McNally Keehn R, Dydak U, Keehn B. Associations between sensory processing and electrophysiological and neurochemical measures in children with ASD: an EEG-MRS study. J Neurodev Disord 2021; 13:5. [PMID: 33407072 PMCID: PMC7788714 DOI: 10.1186/s11689-020-09351-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/14/2020] [Indexed: 12/15/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is associated with hyper- and/or hypo-sensitivity to sensory input. Spontaneous alpha power, which plays an important role in shaping responsivity to sensory information, is reduced across the lifespan in individuals with ASD. Furthermore, an excitatory/inhibitory imbalance has also been linked to sensory dysfunction in ASD and has been hypothesized to underlie atypical patterns of spontaneous brain activity. The present study examined whether resting-state alpha power differed in children with ASD as compared to TD children, and investigated the relationships between alpha levels, concentrations of excitatory and inhibitory neurotransmitters, and atypical sensory processing in ASD. Methods Participants included thirty-one children and adolescents with ASD and thirty-one age- and IQ-matched typically developing (TD) participants. Resting-state electroencephalography (EEG) was used to obtain measures of alpha power. A subset of participants (ASD = 16; TD = 16) also completed a magnetic resonance spectroscopy (MRS) protocol in order to measure concentrations of excitatory (glutamate + glutamine; Glx) and inhibitory (GABA) neurotransmitters. Results Children with ASD evidenced significantly decreased resting alpha power compared to their TD peers. MRS estimates of GABA and Glx did not differ between groups with the exception of Glx in the temporal-parietal junction. Inter-individual differences in alpha power within the ASD group were not associated with region-specific concentrations of GABA or Glx, nor were they associated with sensory processing differences. However, atypically decreased Glx was associated with increased sensory impairment in children with ASD. Conclusions Although we replicated prior reports of decreased alpha power in ASD, atypically reduced alpha was not related to neurochemical differences or sensory symptoms in ASD. Instead, reduced Glx in the temporal-parietal cortex was associated with greater hyper-sensitivity in ASD. Together, these findings may provide insight into the neural underpinnings of sensory processing differences present in ASD. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-020-09351-0.
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Affiliation(s)
- Sarah Pierce
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Girija Kadlaskar
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, USA
| | - David A Edmondson
- Cincinnati Children's Hospital Medical Center, Imaging Research Center, Cincinnati, OH, USA
| | - Rebecca McNally Keehn
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, West Lafayette, IN, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brandon Keehn
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA. .,Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, USA.
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Feldman JI, Cassidy M, Liu Y, Kirby AV, Wallace MT, Woynaroski TG. Relations between Sensory Responsiveness and Features of Autism in Children. Brain Sci 2020; 10:brainsci10110775. [PMID: 33114357 PMCID: PMC7690864 DOI: 10.3390/brainsci10110775] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 01/15/2023] Open
Abstract
Autism is a neurodevelopmental condition defined by differences in social communication and by the presence of restricted and repetitive patterns of behavior, interests, and activities (RRBs). Individuals with autism also commonly present with atypical patterns of sensory responsiveness (i.e., hyporesponsiveness, hyperresponsiveness, and sensory seeking), which are theorized to produce cascading effects across other domains of development. The purpose of this study was to examine differences in sensory responsiveness in children with and without autism (ages 8–18 years), as well as relations between patterns of sensory responsiveness and core and related features of autism. Participants were 50 children with autism and 50 non-autistic peers matched on age and sex. A comprehensive clinical battery included multiple measures of sensory responsiveness, core features of autism, adaptive behavior, internalizing behaviors, cognitive ability, and language ability. Groups significantly differed on all three patterns of sensory responsiveness. Some indices of core and related autism features were robustly associated with all three patterns of sensory responsiveness (e.g., RRBs), while others were more strongly associated with discrete patterns of sensory responsiveness (i.e., internalizing problem behaviors and hyperresponsiveness, language and sensory seeking). This study extends prior work to show that differences in sensory responsiveness that are linked with core and related features of autism persist in older children and adolescents on the spectrum.
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Affiliation(s)
- Jacob I. Feldman
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (M.T.W.); (T.G.W.)
- Correspondence: ; Tel.: +1-615-936-5470
| | - Margaret Cassidy
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN 37232, USA; (M.C.); (Y.L.)
- National Institutes of Health, Bethesda, MD 20814, USA
| | - Yupeng Liu
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN 37232, USA; (M.C.); (Y.L.)
- Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Anne V. Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT 84112, USA;
| | - Mark T. Wallace
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (M.T.W.); (T.G.W.)
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN 37232, USA
- Department of Psychology, Vanderbilt University, Nashville, TN 37232, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA
| | - Tiffany G. Woynaroski
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (M.T.W.); (T.G.W.)
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN 37232, USA
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Dwyer P, Saron CD, Rivera SM. Identification of Longitudinal Sensory Subtypes in Typical Development and Autism Spectrum Development Using Growth Mixture Modelling. RESEARCH IN AUTISM SPECTRUM DISORDERS 2020; 78:101645. [PMID: 32944065 PMCID: PMC7491753 DOI: 10.1016/j.rasd.2020.101645] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Prior longitudinal investigations of trajectories of sensory features in Autism Spectrum Development (ASD) have not explored heterogeneity. The present study explores initial levels and trajectories of sensory features in ASD as well as, for comparison, typical development. METHOD Growth mixture modelling was used to explore classes of autistic and typically-developing participants based on caregiver-reported total sensory behaviours on the Short Sensory Profile (SSP) at two time points, when children were aged 2-5 and 4-10 years of age, respectively. RESULTS Three classes are described: a mixed class of autistic and typically-developing participants with few problematic sensory behaviours ("Stable Mild"), a mostly-autistic class with more problematic sensory features ("Stable Intense"), and a small class of autistic participants whose sensory features reportedly worsened ("Increasingly Intense"). Autistic participants in the Stable Intense class exhibited high anxiety, while autistic participants in the Increasingly Intense class appeared to obtain high scores on cognitive assessments. CONCLUSIONS The heterogeneity of sensory features and challenges found in the present study may suggest that practitioners should conduct individualized assessments of sensory features in ASD. Furthermore, practitioners should be aware of links between sensory features and anxiety in ASD, which may imply that sensory accommodations and supports could protect against anxiety. Finally, the worsening of sensory features over time in the Increasingly Intense subgroup may indicate a need for continued monitoring of changes in sensory features, perhaps especially as sensory environments change during periods of transition.
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Affiliation(s)
- Patrick Dwyer
- Center for Mind and Brain, UC Davis, 267 Cousteau Place, Davis, CA, USA 95618
| | | | - Susan M Rivera
- Department of Psychology, UC Davis, Center for Mind and Brain, UC Davis, MIND Institute, UC Davis
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Dellapiazza F, Michelon C, Oreve MJ, Robel L, Schoenberger M, Chatel C, Vesperini S, Maffre T, Schmidt R, Blanc N, Vernhet C, Picot MC, Baghdadli A. The Impact of Atypical Sensory Processing on Adaptive Functioning and Maladaptive Behaviors in Autism Spectrum Disorder During Childhood: Results From the ELENA Cohort. J Autism Dev Disord 2020; 50:2142-2152. [PMID: 30868365 DOI: 10.1007/s10803-019-03970-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Atypical sensory processing is common in autism spectrum disorders (ASD), but their role in adaptive difficulties and problem behaviors is poorly understood. Our aim was to determine the prevalence and type of atypical sensory processing in children with ASD and investigate its impact on their adaptive functioning and maladaptive behaviors. We studied a subsample of 197 children rigorously diagnosed with ASD from the ELENA cohort. Children were divided into atypical and typical sensory processing groups and several independent variables were compared, including adaptive functioning and maladaptive behaviors. Overall, 86.8% of the children had at least one atypical sensory pattern and all sensory modalities were disturbed. Atypical sensory processing explained a significant part of the variance of behavioral problems.
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Affiliation(s)
- Florine Dellapiazza
- Department of Psychiatry and Autism Resources Center, University Research and Hospital Center (CHU) of Montpellier, 34000, Montpellier, France.,Centre de Recherche en Épidémiologie et Santé des Populations, U1178, INSERM, Paris, France.,Univ Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | - Cécile Michelon
- Department of Psychiatry and Autism Resources Center, University Research and Hospital Center (CHU) of Montpellier, 34000, Montpellier, France
| | - Marie-Joelle Oreve
- Department of Child and Adolescent Psychiatry, Centre Hospitalier de Versailles, Université de Versailles Saint-Quentin-en-Yvelines, Le Chesnay, France
| | - Laurence Robel
- Service de Pédopsychiatrie, Hôpital Necker Enfants Malades, AP-HP, Paris V, Paris, France
| | | | | | - Stéphanie Vesperini
- Autism Resources Centre, Child and Adolescent Psychiatry Department, University Hospital CHU-Lenval, Nice, France
| | - Thierry Maffre
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Hôpital La Grave, Toulouse, France.,Centre de Ressources Autisme Midi-Pyrénées, Hôpital La Grave, Toulouse, France
| | - Richard Schmidt
- Department of Psychology, College of the Holy Cross, Worcester, MA, USA
| | - Nathalie Blanc
- Univ Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | - Christelle Vernhet
- Department of Psychiatry and Autism Resources Center, University Research and Hospital Center (CHU) of Montpellier, 34000, Montpellier, France.,Centre de Recherche en Épidémiologie et Santé des Populations, U1178, INSERM, Paris, France.,Univ Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, 34000, Montpellier, France
| | | | - Amaria Baghdadli
- Department of Psychiatry and Autism Resources Center, University Research and Hospital Center (CHU) of Montpellier, 34000, Montpellier, France. .,Centre de Recherche en Épidémiologie et Santé des Populations, U1178, INSERM, Paris, France. .,School of Medicine, Montpellier University, Montpellier, France.
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Nowell SW, Watson LR, Crais ER, Baranek GT, Faldowski RA, Turner-Brown L. Joint Attention and Sensory-Regulatory Features at 13 and 22 Months as Predictors of Preschool Language and Social-Communication Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3100-3116. [PMID: 32810416 DOI: 10.1044/2020_jslhr-20-00036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The purpose of this study was to understand how joint attention and sensory-regulatory features are related in early childhood and predict language and social-communication outcomes in preschool in order to build mechanistic theories that can inform early intervention directed at improving these outcomes. Method Cross-lagged panel analysis models were used to examine the association between joint attention and sensory-regulatory features at 13 and 22 months of age in children (n = 87) who were identified via community screening at 12 months as having a higher likelihood than the general population for being diagnosed with autism spectrum disorder. Results Significant concurrent correlations and predictive correlations were found between these constructs at 13 and 22 months. Joint attention skills at 13 months predicted both joint attention and sensory-regulatory features at 22 months. Distal language and social-communication outcomes at preschool age (n = 48) were best predicted by sensory-regulatory features at 22 months. Conclusions Both joint attention and sensory regulation are important factors in the first and second years of life for impacting later preschool language and social-communication outcomes in this sample. These findings may have implications for future early childhood intervention research for children at a higher likelihood for autism spectrum disorder.
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Affiliation(s)
- Sallie W Nowell
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill
| | - Linda R Watson
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill
| | - Elizabeth R Crais
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill
| | - Grace T Baranek
- Chan Division of Occupational Science and Occupational Therapy, The University of Southern California, Los Angeles
| | - Richard A Faldowski
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill
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Piccardi ES, Johnson MH, Gliga T. Explaining individual differences in infant visual sensory seeking. INFANCY 2020; 25:677-698. [PMID: 32748567 PMCID: PMC7496506 DOI: 10.1111/infa.12356] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/05/2019] [Accepted: 06/15/2020] [Indexed: 12/21/2022]
Abstract
Individual differences in infants’ engagement with their environment manifest early in development and are noticed by parents. Three views have been advanced to explain differences in seeking novel stimulation. The optimal stimulation hypothesis suggests that individuals seek further stimulation when they are under‐responsive to current sensory input. The processing speed hypothesis proposes that those capable of processing information faster are driven to seek stimulation more frequently. The information prioritization hypothesis suggests the differences in stimulation seeking index variation in the prioritization of incoming relative to ongoing information processing. Ten‐month‐old infants saw 10 repetitions of a video clip and changes in frontal theta oscillatory amplitude were measured as an index of information processing speed. Stimulus‐locked P1 peak amplitude in response to checkerboards briefly overlaid on the video at random points during its presentation indexed processing of incoming stimulation. Parental report of higher visual seeking did not relate to reduced P1 peak amplitude or to a stronger decrease in frontal theta amplitude with repetition, thus not supporting either the optimal stimulation or the processing speed hypotheses. Higher visual seeking occurred in those infants whose P1 peak amplitude was greater than expected based on their theta amplitude. These findings indicate that visual sensory seeking in infancy is explained by a bias toward novel stimulation, thus supporting the information prioritization hypothesis.
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Affiliation(s)
- Elena Serena Piccardi
- Centre for Brain and Cognitive Development, Birkbeck University of London, London, UK
| | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck University of London, London, UK.,Department of Psychology, Cambridge University, Cambridge, UK
| | - Teodora Gliga
- Centre for Brain and Cognitive Development, Birkbeck University of London, London, UK.,Department of Psychology, University of East Anglia, Norwich, UK
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Feldman JI, Dunham K, Conrad JG, Simon DM, Cassidy M, Liu Y, Tu A, Broderick N, Wallace MT, Woynaroski TG. Plasticity of Temporal Binding in Children with Autism Spectrum Disorder:A Single Case Experimental Design Perceptual Training Study. RESEARCH IN AUTISM SPECTRUM DISORDERS 2020; 74:101555. [PMID: 32440308 PMCID: PMC7241431 DOI: 10.1016/j.rasd.2020.101555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Many children with autism spectrum disorder (ASD) demonstrate atypical responses to multisensory stimuli. These disruptions, which are frequently seen in response to audiovisual speech, may produce cascading effects on the broader development of children with ASD. Perceptual training has been shown to enhance multisensory speech perception in typically developed adults. This study was the first to examine the effects of perceptual training on audiovisual speech perception in children with ASD. METHOD A multiple baseline across participants design was utilized with four 7- to 13-year-old children with ASD. The dependent variable, which was probed outside the training task each day using a simultaneity judgment task in baseline, intervention, and maintenance conditions, was audiovisual temporal binding window (TBW), an index of multisensory temporal acuity. During perceptual training, participants completed the same simultaneity judgment task with feedback on their accuracy after each trial in easy-, medium-, and hard-difficulty blocks. RESULTS A functional relation between the multisensory perceptual training program and TBW size was not observed. Of the three participants who were entered into training, one participant demonstrated a strong effect, characterized by a fairly immediate change in TBW trend. The two remaining participants demonstrated a less clear response (i.e., longer latency to effect, lack of functional independence). The first participant to enter the training condition demonstrated some maintenance of a narrower TBW post-training. CONCLUSIONS Results indicate TBWs in children with ASD may be malleable, but additional research is needed and may entail further adaptation to the multisensory perceptual training paradigm.
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Affiliation(s)
- Jacob I. Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University, MCE 8310 South Tower, 1215 21st Avenue South, Nashville, TN 37232
| | - Kacie Dunham
- Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Nashville, TN, USA
- Neuroscience Graduate Program, Vanderbilt University, Nashville, TN, USA
| | - Julie G. Conrad
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- Present Address: College of Medicine, University of Illinois, Chicago, IL, USA
| | - David M. Simon
- Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Nashville, TN, USA
- Neuroscience Graduate Program, Vanderbilt University, Nashville, TN, USA
- Present Address: axialHealthcare, Nashville, TN, USA
| | - Margaret Cassidy
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Yupeng Liu
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Alexander Tu
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- Present Address: College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Neill Broderick
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark T. Wallace
- Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Tiffany G. Woynaroski
- Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Umesawa Y, Atsumi T, Chakrabarty M, Fukatsu R, Ide M. GABA Concentration in the Left Ventral Premotor Cortex Associates With Sensory Hyper-Responsiveness in Autism Spectrum Disorders Without Intellectual Disability. Front Neurosci 2020; 14:482. [PMID: 32508576 PMCID: PMC7248307 DOI: 10.3389/fnins.2020.00482] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/20/2020] [Indexed: 12/29/2022] Open
Abstract
Individuals with autism spectrum disorder (ASD) often exhibit abnormal processing of sensory inputs from multiple modalities and higher-order cognitive/behavioral response to those inputs. Several lines of evidence suggest that altered γ-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the brain, is a central characteristic of the neurophysiology of ASD. The relationship between GABA in particular brain regions and atypical sensory processing in ASD is poorly understood. We therefore employed 1H magnetic resonance spectroscopy (1H-MRS) to examine whether GABA levels in brain regions critical to higher-order motor and/or multiple sensory functions were associated with abnormal sensory responses in ASD. We evaluated atypical sensory processing with a clinically-validated assessment tool. Furthermore, we measured GABA levels in four regions: one each in the primary visual cortex, the left sensorimotor cortex, the left supplementary motor area (SMA), and the left ventral premotor cortex (vPMC). The latter two regions are thought to be involved in executing and coordinating cognitive and behavioral functions in response to multisensory inputs. We found severer sensory hyper-responsiveness in ASD relative to control participants. We also found reduced GABA concentrations in the left SMA but no differences in other regions of interest between ASD and control participants. A correlation analysis revealed a negative association between left vPMC GABA and the severity of sensory hyper-responsiveness across all participants, and the independent ASD group. These findings suggest that reduced inhibitory neurotransmission (reduced GABA) in a higher-order motor area, which modulates motor commands and integrates multiple sensory modalities, may underlie sensory hyper-responsiveness in ASD.
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Affiliation(s)
- Yumi Umesawa
- Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.,Department of Medical Physiology, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Takeshi Atsumi
- Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.,Department of Medical Physiology, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Mrinmoy Chakrabarty
- Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.,Department of Social Sciences and Humanities, Indraprastha Institute of Information Technology (IIIT-D), New Delhi, India
| | - Reiko Fukatsu
- Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
| | - Masakazu Ide
- Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
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Riva V, Marino C, Piazza C, Riboldi EM, Mornati G, Molteni M, Cantiani C. Paternal-but Not Maternal-Autistic Traits Predict Frontal EEG Alpha Asymmetry in Infants with Later Symptoms of Autism. Brain Sci 2019; 9:brainsci9120342. [PMID: 31779221 PMCID: PMC6956226 DOI: 10.3390/brainsci9120342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/23/2019] [Accepted: 11/24/2019] [Indexed: 01/01/2023] Open
Abstract
Previous research found that the parental autism phenotype is associated with child autism spectrum disorder (ASD), even if the pathway between autistic traits in parents and child ASD is still largely unknown. Several studies investigated frontal asymmetry in alpha oscillation (FAA) as an early marker for ASD. However, no study has examined the mediational effect of FAA between parental autistic traits and child ASD symptoms in the general population. We carried out a prospective study of 103 typically developing infants and measured FAA as a mediator between both maternal and paternal autistic traits and child ASD traits. We recorded infant baseline electroencephalogram (EEG) at 6 months of age. Child ASD symptoms were measured at age 24 months by the Child Behavior Checklist 1½-5 Pervasive Developmental Problems Scale, and parental autistic traits were scored by the Autism spectrum Quotient questionnaire. The mediation model showed that paternal vs. maternal autistic traits are associated with greater left FAA which, in turn, is associated with more child ASD traits with a significant indirect effect only in female infants vs. male infants. Our findings show a potential cascade of effects whereby paternal autistic traits drive EEG markers contributing to ASD risk.
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Affiliation(s)
- Valentina Riva
- Child Psychopathology Unit, Scientific Institute IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (E.M.R.); (G.M.); (M.M.); (C.C.)
- Correspondence: ; Tel.: +39-031-877924; Fax: +39-031-877499
| | - Cecilia Marino
- Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON M6J 1H4, Canada;
| | - Caterina Piazza
- Bioengineering Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy;
| | - Elena M Riboldi
- Child Psychopathology Unit, Scientific Institute IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (E.M.R.); (G.M.); (M.M.); (C.C.)
| | - Giulia Mornati
- Child Psychopathology Unit, Scientific Institute IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (E.M.R.); (G.M.); (M.M.); (C.C.)
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (E.M.R.); (G.M.); (M.M.); (C.C.)
| | - Chiara Cantiani
- Child Psychopathology Unit, Scientific Institute IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (E.M.R.); (G.M.); (M.M.); (C.C.)
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43
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Self-reported Sensory Hypersensitivity Moderates Association Between Tactile Psychophysical Performance and Autism-Related Traits in Neurotypical Adults. J Autism Dev Disord 2019; 49:3159-3172. [PMID: 31073751 DOI: 10.1007/s10803-019-04043-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Atypical responses to tactile stimulation have been linked to core domains of dysfunction in individuals with autism spectrum disorder (ASD) and phenotypic traits associated with ASD in neurotypical individuals. We investigated (a) the extent to which two psychophysically derived measures of tactile sensitivity-detection threshold and dynamic range-relate to traits associated with ASD and (b) whether those relations vary according to the presence of self-reported sensory hypersensitivities in neurotypical individuals. A narrow dynamic range was associated with increased autism-related traits in individuals who reported greater sensory hypersensitivity. In contrast, in individuals less prone to sensory hypersensitivity, a narrow dynamic range was associated with reduced autism-related traits. Findings highlight the potential importance of considering dynamic psychophysical metrics in future studies.
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Kojovic N, Ben Hadid L, Franchini M, Schaer M. Sensory Processing Issues and Their Association with Social Difficulties in Children with Autism Spectrum Disorders. J Clin Med 2019; 8:E1508. [PMID: 31547076 PMCID: PMC6833094 DOI: 10.3390/jcm8101508] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/11/2019] [Accepted: 09/18/2019] [Indexed: 01/08/2023] Open
Abstract
Sensory processing issues have been frequently reported in individuals with Autism Spectrum Disorders (ASD), but their relationship with social and overall adaptive functioning has not been extensively characterized to date. Here, we investigate how sensory processing atypicalities relate with deficits in social skills, impaired social cognition, and general adaptive functioning in a group of preschoolers with ASD. Sixty-four children with ASD aged 3 to 6 were included in this study, along with 36 age-matched typically-developing (TD) peers. Parent-reported measures of sensory processing, social difficulties and overall adaptive functioning were collected for all children. We also obtained precise measures of social attention deployment using a custom-design eye-tracking task depicting naturalistic social scenes. Within the group of children with ASD, higher intensities of sensory issues were associated with more prominent social difficulties and lower adaptive functioning. We also found that children with ASD who had more sensory issues showed visual exploration patterns of social scenes that strongly deviated from the one seen in the TD group. The association of sensory processing atypicalities with "higher-order" functional domains such as social and adaptive functioning in children with ASD stresses the importance of further research on sensory symptoms in autism.
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Affiliation(s)
- Nada Kojovic
- University of Geneva, 1211 Geneva, Switzerland (M.S.)
| | | | | | - Marie Schaer
- University of Geneva, 1211 Geneva, Switzerland (M.S.)
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45
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Mason GM, Goldstein MH, Schwade JA. The role of multisensory development in early language learning. J Exp Child Psychol 2019; 183:48-64. [PMID: 30856417 DOI: 10.1016/j.jecp.2018.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 01/11/2023]
Abstract
In typical development, communicative skills such as language emerge from infants' ability to combine multisensory information into cohesive percepts. For example, the act of associating the visual or tactile experience of an object with its spoken name is commonly used as a measure of early word learning, and social attention and speech perception frequently involve integrating both visual and auditory attributes. Early perspectives once regarded perceptual integration as one of infants' primary challenges, whereas recent work suggests that caregivers' social responses contain structured patterns that may facilitate infants' perception of multisensory social cues. In the current review, we discuss the regularities within caregiver feedback that may allow infants to more easily discriminate and learn from social signals. We focus on the statistical regularities that emerge in the moment-by-moment behaviors observed in studies of naturalistic caregiver-infant play. We propose that the spatial form and contingencies of caregivers' responses to infants' looks and prelinguistic vocalizations facilitate communicative and cognitive development. We also explore how individual differences in infants' sensory and motor abilities may reciprocally influence caregivers' response patterns, in turn regulating and constraining the types of social learning opportunities that infants experience across early development. We end by discussing implications for neurodevelopmental conditions affecting both multisensory integration and communication (i.e., autism) and suggest avenues for further research and intervention.
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Affiliation(s)
- Gina M Mason
- Department of Psychology, Cornell University, Ithaca, NY 14853, USA.
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46
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Feldman JI, Dunham K, Cassidy M, Wallace MT, Liu Y, Woynaroski TG. Audiovisual multisensory integration in individuals with autism spectrum disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2018; 95:220-234. [PMID: 30287245 PMCID: PMC6291229 DOI: 10.1016/j.neubiorev.2018.09.020] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/10/2018] [Accepted: 09/25/2018] [Indexed: 02/04/2023]
Abstract
An ever-growing literature has aimed to determine how individuals with autism spectrum disorder (ASD) differ from their typically developing (TD) peers on measures of multisensory integration (MSI) and to ascertain the degree to which differences in MSI are associated with the broad range of symptoms associated with ASD. Findings, however, have been highly variable across the studies carried out to date. The present work systematically reviews and quantitatively synthesizes the large literature on audiovisual MSI in individuals with ASD to evaluate the cumulative evidence for (a) group differences between individuals with ASD and TD peers, (b) correlations between MSI and autism symptoms in individuals with ASD and (c) study level factors that may moderate findings (i.e., explain differential effects) observed across studies. To identify eligible studies, a comprehensive search strategy was employed using the ProQuest search engine, PubMed database, forwards and backwards citation searches, direct author contact, and hand-searching of select conference proceedings. A significant between-group difference in MSI was evident in the literature, with individuals with ASD demonstrating worse audiovisual integration on average across studies compared to TD controls. This effect was moderated by mean participant age, such that between-group differences were more pronounced in younger samples. The mean correlation between MSI and autism and related symptomatology was also significant, indicating that increased audiovisual integration in individuals with ASD is associated with better language/communication abilities and/or reduced autism symptom severity in the extant literature. This effect was moderated by whether the stimuli were linguistic versus non-linguistic in nature, such that correlation magnitudes tended to be significantly greater when linguistic stimuli were utilized in the measure of MSI. Limitations and future directions for primary and meta-analytic research are discussed.
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Affiliation(s)
- Jacob I Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Ave S, MCE South Tower 8310, Nashville, TN, 37232, USA.
| | - Kacie Dunham
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Margaret Cassidy
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Mark T Wallace
- Department of Psychology, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pharmacology, Vanderbilt University, Nashville, TN, USA; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, USA; Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Nashville, TN, 37232, USA; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Ave S, MCE South Tower 8310, Nashville, TN, 27323, USA.
| | - Yupeng Liu
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Tiffany G Woynaroski
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, USA; Vanderbilt Brain Institute, Vanderbilt University, 465 21st Avenue South, Nashville, TN, 37232, USA; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Ave S, MCE South Tower 8310, Nashville, TN, 27323, USA.
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47
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Baranek GT, Carlson M, Sideris J, Kirby AV, Watson LR, Williams KL, Bulluck J. Longitudinal assessment of stability of sensory features in children with autism spectrum disorder or other developmental disabilities. Autism Res 2018; 12:100-111. [PMID: 30194913 DOI: 10.1002/aur.2008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/17/2018] [Accepted: 07/01/2018] [Indexed: 12/22/2022]
Abstract
Prior research on the stability of sensory processing problems in children with autism spectrum disorder (ASD) or other developmental disabilities (DD) has produced inconsistent results. We employed a longitudinal study design to assess the stability of three clinical sensory response patterns: hyporesponsiveness; hyperresponsiveness; and sensory interests, repetitions, and seeking behaviors (SIRS). Parents of children with ASD (n = 55) or DD (n = 35) responded to sensory questionnaires at two time points (T1 and T2) separated by 3.3 years on average, with the children aged 2-12 years (M = 5.69 ± 2.46) at the first assessment. For each sensory response pattern, regression analysis revealed that, for both ASD and DD groups, scores at T1 were strong predictors of scores at T2. Over the longitudinal assessment interval, there was a significant mean decline in severity for SIRS in both groups and for hyporesponsiveness in the ASD group. Parental estimates of the amount of therapy services received were positively associated with the severity of sensory features at T2, an outcome that may result from increased intervention dosages being administered to children who fail to improve over time. The results are discussed in terms of person-centered and environmental considerations, which, in combination, have the capacity to affect stability outcomes for sensory features. Autism Research 2019, 12: 100-111. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorder (ASD) and other developmental disabilities (DD) may process sensory information differently from those who do not have ASD. For example, some children may be over-responsive or under-responsive to sound or touch. In this study, we showed that sensory features in preschool/school-aged children with ASD and DD tend to decrease on average over a several year period. However, individual children tend to retain their ranking (low or high in sensory features) in comparison to other children over time.
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Affiliation(s)
- Grace T Baranek
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California.,Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mike Carlson
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California
| | - John Sideris
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California
| | - Anne V Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah
| | - Linda R Watson
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn L Williams
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John Bulluck
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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48
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Bian D, Zheng Z, Swanson A, Weitlauf A, Woynaroski T, Cascio CJ, Key AP, Warren Z, Sarkar N. A Novel Multisensory Stimulation and Data Capture System (MADCAP) for Investigating Sensory Trajectories in Infancy. IEEE Trans Neural Syst Rehabil Eng 2018; 26:1526-1534. [PMID: 30004880 PMCID: PMC9430828 DOI: 10.1109/tnsre.2018.2854672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Sensory processing differences, including responses to auditory, visual, and tactile stimuli, are ideal targets for early detection of neurodevelopmental risks, such as autism spectrum disorder. However, most existing studies focus on the audiovisual paradigm and ignore the sense of touch. In this paper, we present a multisensory delivery system that can deliver audio, visual, and tactile stimuli in a controlled manner and capture peripheral physiological, eye gaze, and electroencephalographic response data. The novelty of the system is the ability to provide affective touch. In particular, we have developed a tactile stimulation device that delivers tactile stimuli to infants with precisely controlled brush stroking speed and force on the skin. A usability study of 10 3-20 month-old infants was conducted to investigate the tolerability and feasibility of the system. Results have shown that the system is well tolerated by infants and all the data were collected robustly. This paper paves the way for future studies charting the sensory response trajectories in infancy.
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49
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Hamilton A, Pelphrey K. Sensory and social features of autism - can they be integrated? Dev Cogn Neurosci 2018; 29:1-3. [PMID: 29563025 PMCID: PMC6987863 DOI: 10.1016/j.dcn.2018.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Kevin Pelphrey
- Autism & Neurodevelopmental Disorders Institute, The George Washington University & Children's National Health System
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50
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Baranek GT, Woynaroski TG, Nowell S, Turner-Brown L, DuBay M, Crais ER, Watson LR. Cascading effects of attention disengagement and sensory seeking on social symptoms in a community sample of infants at-risk for a future diagnosis of autism spectrum disorder. Dev Cogn Neurosci 2018; 29:30-40. [PMID: 28869201 PMCID: PMC6414208 DOI: 10.1016/j.dcn.2017.08.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 07/18/2017] [Accepted: 08/09/2017] [Indexed: 01/05/2023] Open
Abstract
Recent work suggests sensory seeking predicts later social symptomatology through reduced social orienting in infants who are at high-risk for autism spectrum disorder (ASD) based on their status as younger siblings of children diagnosed with ASD. We drew on extant longitudinal data from a community sample of at-risk infants who were identified at 12 months using the First Year Inventory, and followed to 3-5 years. We replicate findings of Damiano et al. (in this issue) that a) high-risk infants who go on to be diagnosed with ASD show heightened sensory seeking in the second year of life relative to those who do not receive a diagnosis, and b) increased sensory seeking indirectly relates to later social symptomatology via reduced social orienting. We extend previous findings to show that sensory seeking has more clinical utility later in the second year of life (20-24 months) than earlier (13-15 months). Further, this study suggests that diminished attention disengagement at 12-15 months may precede and predict increased sensory seeking at 20-24 months. Findings add support for the notion that sensory features produce cascading effects on social development in infants at risk for ASD, and suggest that reduced attention disengagement early in life may set off this cascade.
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Affiliation(s)
- Grace T Baranek
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Kennedy Center, Nashville, TN, USA; Vanderbilt Brain Institute, Nashville, TN, USA
| | - Sallie Nowell
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Speech and Hearing Sciences, Department of Allied Health Sciences University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren Turner-Brown
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michaela DuBay
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Speech and Hearing Sciences, Department of Allied 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; Division of Speech and Hearing Sciences, Department of Allied Health Sciences 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; Division of Speech and Hearing Sciences, Department of Allied Health Sciences University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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