Development of neural responses to hearing their own name in infants at low and high risk for autism spectrum disorder

Neural correlates and predictors of speech and language development in infants at elevated likelihood for autism: a systematic review

Autism spectrum disorder (ASD) is an increasingly prevalent and heterogeneous neurodevelopmental condition, characterized by social communicative differences, and a combination of repetitive behaviors, focused interests, and sensory sensitivities. Early speech and language delays are characteristic of young autistic children and are one of the first concerns reported by parents; often before their child's second birthday. Elucidating the neural mechanisms underlying these delays has the potential to improve early detection and intervention efforts. To fill this gap, this systematic review aimed to synthesize evidence on early neurobiological correlates and predictors of speech and language development across different neuroimaging modalities in infants with and without a family history of autism [at an elevated (EL infants) and low likelihood (LL infants) for developing autism, respectively]. A comprehensive, systematic review identified 24 peer-reviewed articles published between 2012 and 2023, utilizing structural magnetic resonance imaging (MRI; n = 2), functional MRI (fMRI; n = 4), functional near-infrared spectroscopy (fNIRS; n = 4), and electroencephalography (EEG; n = 14). Three main themes in results emerged: compared to LL infants, EL infants exhibited (1) atypical language-related neural lateralization; (2) alterations in structural and functional connectivity; and (3) mixed profiles of neural sensitivity to speech and non-speech stimuli, with some differences detected as early as 6 weeks of age. These findings suggest that neuroimaging techniques may be sensitive to early indicators of speech and language delays well before overt behavioral delays emerge. Future research should aim to harmonize experimental paradigms both within and across neuroimaging modalities and additionally address the feasibility, acceptability, and scalability of implementing such methodologies in non-academic, community-based settings.

Relationship between quantitative digital behavioral features and clinical profiles in young autistic children

Early behavioral markers for autism include differences in social attention and orienting in response to one's name when called, and differences in body movements and motor abilities. More efficient, scalable, objective, and reliable measures of these behaviors could improve early screening for autism. This study evaluated whether objective and quantitative measures of autism-related behaviors elicited from an app (SenseToKnow) administered on a smartphone or tablet and measured via computer vision analysis (CVA) are correlated with standardized caregiver-report and clinician administered measures of autism-related behaviors and cognitive, language, and motor abilities. This is an essential step in establishing the concurrent validity of a digital phenotyping approach. In a sample of 485 toddlers, 43 of whom were diagnosed with autism, we found that CVA-based gaze variables related to social attention were associated with the level of autism-related behaviors. Two language-related behaviors measured via the app, attention to people during a conversation and responding to one's name being called, were associated with children's language skills. Finally, performance during a bubble popping game was associated with fine motor skills. These findings provide initial support for the concurrent validity of the SenseToKnow app and its potential utility in identifying clinical profiles associated with autism. Future research is needed to determine whether the app can be used as an autism screening tool, can reliably stratify autism-related behaviors, and measure changes in autism-related behaviors over time.

Language comprehension in toddlers with significant developmental delays: An IRT approach

PURPOSE

Language comprehension, or the ability to understand spoken language, is critical to a variety of child outcomes. Effective early intervention relies on valid, reliable language comprehension assessment. The purpose of this study was to explore language comprehension in a sample of toddlers with significant developmental delays associated with varied medical conditions.

METHOD

We investigated language comprehension in a sample of 112 toddlers by applying Item Response Theory (IRT) methods to two measures; one standardized and one flexible.

RESULTS

Data from a standardized measure fit the unidimensional model, whereas the flexible measure did not. The overall pattern of results suggested that items related to early social/contextual comprehension are distinct from linguistic comprehension items.

CONCLUSION

Our findings inform clinical practice by underscoring the importance of comprehensive assessment of language comprehension and considering strengths and weaknesses across social/contextual and linguistic comprehension among toddlers with developmental delays.

The Value of Brain Imaging and Electrophysiological Testing for Early Screening of Autism Spectrum Disorder: A Systematic Review

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.

Peak selection and latency jitter correction in developmental event-related potentials

Event-related potentials (ERPs) provide great insight into neural responses, yet developmental ERP work is plagued with inconsistent approaches to identifying and quantifying component latency. In this analytical review, we describe popular conventions for the selection of time windows for ERP analysis and assert that a data-driven strategy should be applied to the identification of component latency within individual participants' data. This may overcome weaknesses of more general approaches to peak selection; however, it does not account for trial-by-trial variability within a participant. This issue, known as ERP latency jitter, may blur the average ERP, misleading the interpretation of neural mechanisms. Recently, the ReSync MATLAB toolbox has been made available for correction of latency jitter. Although not created specifically for pediatric ERP data, this approach can be adapted for developmental researchers. We have demonstrated the use of the ReSync toolbox with individual infant and child datasets to illustrate its utility. Details about our peak detection script and the ReSync toolbox are provided. The adoption of data processing procedures that allow for accurate, study-specific component selection and reduce trial-by-trial asynchrony strengthens developmental ERP research by decreasing noise included in ERP analyses and improving the representation of the neural response.

Did you say my name? Congruency of 12-month-old infants' behavioral and cardiac responses to name

Reduced orienting to name is an early behavioral risk marker for neurodevelopmental disorders. However, individual instances of infants' behavioral responses to name are limited in both reliability and predictive validity. Physiological responses such as heart rate (HR) deceleration may serve as more sensitive metrics than behavioral methods. As a first step toward validating HR deceleration as a candidate psychophysiological measure of name processing, we examined the congruency of behavioral and cardiac responses to name in 12-month-old typically developing infants. Infants exhibited greater median HR deceleration and spent a larger proportion of time in HR deceleration when they behaviorally oriented to their names than when they failed to do so; however, maximum HR deceleration was not related to behavioral responses. These findings provide preliminary evidence that specific HR deceleration metrics may be useful indices of infants' responses to name and may inform psychophysiological mechanisms underlying behavioral responses.

Self-Related Stimuli Decoding With Auditory and Visual Modalities Using Stereo-Electroencephalography

Name recognition plays important role in self-related cognitive processes and also contributes to a variety of clinical applications, such as autism spectrum disorder diagnosis and consciousness disorder analysis. However, most previous name-related studies usually adopted noninvasive EEG or fMRI recordings, which were limited by low spatial resolution and temporal resolution, respectively, and thus millisecond-level response latencies in precise brain regions could not be measured using these noninvasive recordings. By invasive stereo-electroencephalography (SEEG) recordings that have high resolution in both the spatial and temporal domain, the current study distinguished the neural response to one's own name or a stranger's name, and explored common active brain regions in both auditory and visual modalities. The neural activities were classified using spatiotemporal features of high-gamma, beta, and alpha band. Results showed that different names could be decoded using multi-region SEEG signals, and the best classification performance was achieved at high gamma (60–145 Hz) band. In this case, auditory and visual modality-based name classification accuracies were 84.5 ± 8.3 and 79.9 ± 4.6%, respectively. Additionally, some single regions such as the supramarginal gyrus, middle temporal gyrus, and insula could also achieve remarkable accuracies for both modalities, supporting their roles in the processing of self-related information. The average latency of the difference between the two responses in these precise regions was 354 ± 63 and 285 ± 59 ms in the auditory and visual modality, respectively. This study suggested that name recognition was attributed to a distributed brain network, and the subsets with decoding capabilities might be potential implanted regions for awareness detection and cognition evaluation.

Longitudinal Differences in Response to Name Among Infants Developing ASD and Risk for ADHD

Diminished response to name, a potential early marker of autism spectrum disorder (ASD), may also indicate risk for other disorders characterized by attention problems, including attention-deficit/hyperactivity disorder (ADHD). Using a familial risk design, we examined whether response to name ability at 6, 12, 18, 24, and 36 months of age differed between three 36-month outcome groups: ASD, ADHD Concerns, or a Comparison group. Persistent differences between the ASD and Comparison groups were evident beginning at 12 months; differences between the ADHD Concerns and Comparison groups were evident between 12 and 18 months only. Results suggest that response to name may be a general marker for ASD and ADHD risk in infancy but a specific indicator of ASD by 24-months.

Comparison of Auditory Brain Stem Responses and Otoacoustic Emission of Autism with Healthy Children

BACKGROUND

Autism is a neurodevelopment disorder, including difficulty in establishing relationships and social interaction, difficulty in communication, performing restricted, and repetitive behaviors. The impaired reception and integration of sensory information especially auditory data are one of the main characteristics of children with autism. According to various studies, the brain stem plays a key role in the reception and integration of auditory and sensory data. Hence, this study aims to comparison auditory brain stem responses (ABR) and otoacoustic emission (OAE) of autism patients with healthy children.

MATERIALS AND METHODS

This case-control study was performed on 20 autism children (4-8 years old) as case group who referred to psychiatry clinics affiliated with Tabriz University of Medical Sciences and 20 healthy age-matched as the control group. The severity of autism was evaluated by the Gilliam Autism Rating Scale (GARS). Also, ABR and OAE were recorded, and all data compared with the healthy children.

RESULTS

The latencies between the waves III-V and I-V bilaterally, and wave V bilaterally and wave I in the left ear showed a significant increase in children with autism compared to the healthy group.

CONCLUSION

This study shows that there was a reduced nerve conduction velocity in the auditory pathway of the brain stem in children with autism compared to healthy children.

Neural Evidence for Speech Processing Deficits During a Cocktail Party Scenario in Minimally and Low Verbal Adolescents and Young Adults with Autism

As demonstrated by the Cocktail Party Effect, a person's attention is grabbed when they hear their name in a multispeaker setting. However, individuals with autism (ASD) are commonly challenged in multispeaker settings and often do not respond to salient speech, including one's own name (OON). It is unknown whether neural responses during this Cocktail Party scenario differ in those with ASD and whether such differences are associated with expressive language or auditory filtering abilities. We measured neural responses to hearing OON in quiet and multispeaker settings using electroencephalography in 20 minimally or low verbal ASD (ASD-MLV), 27 verbally fluent ASD (ASD-V), and 27 neurotypical (TD) participants, ages 13-22. First, we determined whether TD's neural responses to OON relative to other names could be quantified with early frontal mismatch responses (MMRs) and late, slow shift parietal and frontal responses (LPPs/FNs). Second, we compared the strength of MMRs and LPPs/FNs across the three groups. Third, we tested whether participants with poorer auditory filtering abilities exhibited particularly weak neural responses to OON heard in a multispeaker setting. Our primary finding was that TDs and ASD-Vs, but not ASD-MLVs, had significant MMRs to OON in a multispeaker setting, and strength of LPPs positively correlated with auditory filtering abilities in those with ASD. These findings reveal electrophysiological correlates of auditory filtering disruption within a clinical population that has severe language and communication impairments and offer a novel neuroimaging approach to studying the Cocktail Party effect in neurotypical and clinical populations. Autism Res 2020, 13: 1828-1842. © 2020 International Society for Autism Research and Wiley Periodicals LLC. LAY SUMMARY: We found that minimally and low verbal adolescents and young adults with autism exhibit decreased neural responses to one's own name when heard in a multispeaker setting. In addition, decreased strength of neural responses in those with autism correlated with decreased auditory filtering abilities. We propose that these neural deficits may reflect the ineffective processing of salient speech in noisy settings and contribute to language and communication deficits observed in autism.