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Zhang D, Lang S, Wilken B, Einspieler C, Neul JL, Bölte S, Holzinger D, Freilinger M, Poustka L, Sigafoos J, Marschik PB. Learning about neurodiversity from parents - Auditory gestalt perception of prelinguistic vocalisations. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 138:104515. [PMID: 37104989 DOI: 10.1016/j.ridd.2023.104515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Infants with Rett syndrome (RTT) may have subtle anomalies in their prelinguistic vocalisations but the detection of these is difficult, since their conspicuous vocalisations are often interspersed with inconspicuous ones. AIMS AND METHODS Extending a previous study with predominantly non-parents, the present study sampled parents of children with RTT and aimed to examine their gestalt perception of prelinguistic vocalisations. METHODS AND PROCEDURE Parents (n = 76) of female children with RTT listened to vocalisation recordings from RTT and typically developing (TD) infants, including an inconspicuous vocalisation from a RTT girl. For each recording, parents indicated if the vocalisation was produced by a RTT or a TD child. RESULTS Overall correct to incorrect identification rate was 2:1, which was comparable to that of the previous study. Intriguingly, parents of RTT children seemed to be sensitive to features characterising the vocalisations of RTT infants, which has especially influenced their perception of the inconspicuous vocalisation from a RTT girl. CONCLUSIONS AND IMPLICATIONS These results invite further research on the potential characterising differences between vocalisations from TD infants and infants with divergent neurodevelopment.
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Affiliation(s)
- Dajie Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; iDN-Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria; Leibniz Science Campus Primate Cognition, 37077 Göttingen, Germany.
| | - Sigrun Lang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Bernd Wilken
- Social Pediatric Center, Clinic in Kassel, 34125 Kassel, Germany
| | - Christa Einspieler
- iDN-Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Jeffrey L Neul
- Pediatrics, Pharmacology, and Special Education, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Child and Adolescent Psychiatry, Region Stockholm, Karolinska Institutet & Stockholm Health Care Services, 17176 Stockholm, Sweden; Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Daniel Holzinger
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder Linz, 4020 Linz, Austria; Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Michael Freilinger
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington 6140, New Zealand
| | - Peter B Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; iDN-Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria; Leibniz Science Campus Primate Cognition, 37077 Göttingen, Germany; Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Child and Adolescent Psychiatry, Region Stockholm, Karolinska Institutet & Stockholm Health Care Services, 17176 Stockholm, Sweden
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Reich S, Zhang D, Kulvicius T, Bölte S, Nielsen-Saines K, Pokorny FB, Peharz R, Poustka L, Wörgötter F, Einspieler C, Marschik PB. Novel AI driven approach to classify infant motor functions. Sci Rep 2021; 11:9888. [PMID: 33972661 PMCID: PMC8110753 DOI: 10.1038/s41598-021-89347-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/12/2021] [Indexed: 02/02/2023] Open
Abstract
The past decade has evinced a boom of computer-based approaches to aid movement assessment in early infancy. Increasing interests have been dedicated to develop AI driven approaches to complement the classic Prechtl general movements assessment (GMA). This study proposes a novel machine learning algorithm to detect an age-specific movement pattern, the fidgety movements (FMs), in a prospectively collected sample of typically developing infants. Participants were recorded using a passive, single camera RGB video stream. The dataset of 2800 five-second snippets was annotated by two well-trained and experienced GMA assessors, with excellent inter- and intra-rater reliabilities. Using OpenPose, the infant full pose was recovered from the video stream in the form of a 25-points skeleton. This skeleton was used as input vector for a shallow multilayer neural network (SMNN). An ablation study was performed to justify the network's architecture and hyperparameters. We show for the first time that the SMNN is sufficient to discriminate fidgety from non-fidgety movements in a sample of age-specific typical movements with a classification accuracy of 88%. The computer-based solutions will complement original GMA to consistently perform accurate and efficient screening and diagnosis that may become universally accessible in daily clinical practice in the future.
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Affiliation(s)
- Simon Reich
- University Medical Center Göttingen, Child and Adolescent Psychiatry and Psychotherapy, 37075, Göttingen, Germany
| | - Dajie Zhang
- University Medical Center Göttingen, Child and Adolescent Psychiatry and Psychotherapy, 37075, Göttingen, Germany
- Division of Phoniatrics, Research Unit interdisciplinary Developmental Neuroscience, Medical University of Graz, 8036, Graz, Austria
- Leibniz ScienceCampus Primate Cognition, 37075, Göttingen, Germany
| | - Tomas Kulvicius
- University Medical Center Göttingen, Child and Adolescent Psychiatry and Psychotherapy, 37075, Göttingen, Germany
- Georg-August University Göttingen, Third Institute of Physics-Biophysics, 37077, Göttingen, Germany
| | - Sven Bölte
- Department of Women's and Children's Health, Karolinska Institutet, Center of Neurodevelopmental Disorders (KIND), 113 30, Stockholm, Sweden
| | - Karin Nielsen-Saines
- University of California, David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Florian B Pokorny
- Division of Phoniatrics, Research Unit interdisciplinary Developmental Neuroscience, Medical University of Graz, 8036, Graz, Austria
- University of Augsburg, EIHW-Chair of Embedded Intelligence for Health Care and Wellbeing, 86159, Augsburg, Germany
| | - Robert Peharz
- Department of Mathematics and Computer Science, Eindhoven University of Technology, 5600 MB, Eindhoven, The Netherlands
| | - Luise Poustka
- University Medical Center Göttingen, Child and Adolescent Psychiatry and Psychotherapy, 37075, Göttingen, Germany
- Leibniz ScienceCampus Primate Cognition, 37075, Göttingen, Germany
| | - Florentin Wörgötter
- Leibniz ScienceCampus Primate Cognition, 37075, Göttingen, Germany
- Georg-August University Göttingen, Third Institute of Physics-Biophysics, 37077, Göttingen, Germany
| | - Christa Einspieler
- Division of Phoniatrics, Research Unit interdisciplinary Developmental Neuroscience, Medical University of Graz, 8036, Graz, Austria
| | - Peter B Marschik
- University Medical Center Göttingen, Child and Adolescent Psychiatry and Psychotherapy, 37075, Göttingen, Germany.
- Division of Phoniatrics, Research Unit interdisciplinary Developmental Neuroscience, Medical University of Graz, 8036, Graz, Austria.
- Leibniz ScienceCampus Primate Cognition, 37075, Göttingen, Germany.
- Department of Women's and Children's Health, Karolinska Institutet, Center of Neurodevelopmental Disorders (KIND), 113 30, Stockholm, Sweden.
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Marschik PB, Pokorny FB, Peharz R, Zhang D, O'Muircheartaigh J, Roeyers H, Bölte S, Spittle AJ, Urlesberger B, Schuller B, Poustka L, Ozonoff S, Pernkopf F, Pock T, Tammimies K, Enzinger C, Krieber M, Tomantschger I, Bartl-Pokorny KD, Sigafoos J, Roche L, Esposito G, Gugatschka M, Nielsen-Saines K, Einspieler C, Kaufmann WE. A Novel Way to Measure and Predict Development: A Heuristic Approach to Facilitate the Early Detection of Neurodevelopmental Disorders. Curr Neurol Neurosci Rep 2017; 17:43. [PMID: 28390033 PMCID: PMC5384955 DOI: 10.1007/s11910-017-0748-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Substantial research exists focusing on the various aspects and domains of early human development. However, there is a clear blind spot in early postnatal development when dealing with neurodevelopmental disorders, especially those that manifest themselves clinically only in late infancy or even in childhood. RECENT FINDINGS This early developmental period may represent an important timeframe to study these disorders but has historically received far less research attention. We believe that only a comprehensive interdisciplinary approach will enable us to detect and delineate specific parameters for specific neurodevelopmental disorders at a very early age to improve early detection/diagnosis, enable prospective studies and eventually facilitate randomised trials of early intervention. In this article, we propose a dynamic framework for characterising neurofunctional biomarkers associated with specific disorders in the development of infants and children. We have named this automated detection 'Fingerprint Model', suggesting one possible approach to accurately and early identify neurodevelopmental disorders.
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Affiliation(s)
- Peter B Marschik
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria.
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
- BEE-PRI: Brain, Ears & Eyes-Pattern Recognition Initiative, BioTechMed-Graz, Graz, Austria.
| | - Florian B Pokorny
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria
- BEE-PRI: Brain, Ears & Eyes-Pattern Recognition Initiative, BioTechMed-Graz, Graz, Austria
- Machine Intelligence & Signal Processing group, MMK, Technische Universität München, Munich, Germany
| | - Robert Peharz
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria
- BEE-PRI: Brain, Ears & Eyes-Pattern Recognition Initiative, BioTechMed-Graz, Graz, Austria
| | - Dajie Zhang
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria
| | - Jonathan O'Muircheartaigh
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, King's College London, London, UK
| | - Herbert Roeyers
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Alicia J Spittle
- University of Melbourne, Melbourne, Australia
- Murdoch Childrens Research Institute, Melbourne, Australia
- The Royal Women's Hospital, Melbourne, Australia
| | - Berndt Urlesberger
- Division of Neonatology, Department of Pediatrics and Adolescence Medicine, Medical University of Graz, Graz, Austria
| | - Björn Schuller
- Chair of Complex and Intelligent Systems, University of Passau, Passau, Germany
- Machine Learning Group, Imperial College London, London, UK
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Sally Ozonoff
- MIND Institute, Davis Health System, University of California, Sacramento, CA, USA
| | - Franz Pernkopf
- Signal Processing and Speech Communication Laboratory, Graz University of Technology, Graz, Austria
| | - Thomas Pock
- Institute for Computer Graphics and Vision, Graz University of Technology, Graz, Austria
| | - Kristiina Tammimies
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Christian Enzinger
- Department of Neurology and Division of Neuroradiology, Vascular & Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Magdalena Krieber
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria
| | - Iris Tomantschger
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria
| | - Katrin D Bartl-Pokorny
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Laura Roche
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Gianluca Esposito
- Social & Affective Neuroscience Lab, Division of Psychology-HSS, Nanyang Technological University, Singapore, Singapore
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Markus Gugatschka
- Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Karin Nielsen-Saines
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Christa Einspieler
- Research Unit iDN-interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria.
| | - Walter E Kaufmann
- Center for Translational Research, Greenwood Genetic Center, Greenwood, SC, USA
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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Einspieler C, Freilinger M, Marschik PB. Behavioural biomarkers of typical Rett syndrome: moving towards early identification. Wien Med Wochenschr 2016; 166:333-7. [PMID: 27514944 PMCID: PMC5005386 DOI: 10.1007/s10354-016-0498-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 07/13/2016] [Indexed: 11/30/2022]
Abstract
The dynamic course of Rett syndrome (RTT) is still said to begin with a period of apparently normal development although there is mounting evidence that individuals with RTT show behavioural peculiarities and abnormalities during their infancy. Their spontaneous general movements are abnormal from birth onwards. Normal cooing vocalisation and canonical babbling (if at all required) are interspersed with abnormalities such as proto-vowel and proto-consonant alternations produced on ingressive airstream, breathy voice characteristics, and pressed or high-pitched vocalisations. The gestural repertoire is limited. Certain developmental motor and speech-language milestones are not at all acquired or show a significant delay. Besides abnormal blinking, repetitive and/or long lasting tongue protrusion, and bizarre smiling, there are already the first body and/or hand stereotypies during the first year of life. We are currently on a promising way to define a specific set of behavioural biomarkers pinpointing RTT.
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Affiliation(s)
- Christa Einspieler
- Research Unit iDN, interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria.
| | - Michael Freilinger
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter B Marschik
- Research Unit iDN, interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Harrachgasse 21/5, 8010, Graz, Austria
- Center for Neurodevelopmental Disorders, Department of Women's and Children's Health (KIND), Karolinska Institutet, Stockholm, Sweden
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Progress in Rett Syndrome: from discovery to clinical trials. Wien Med Wochenschr 2016; 166:325-32. [PMID: 27491553 PMCID: PMC5005392 DOI: 10.1007/s10354-016-0491-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 07/04/2016] [Indexed: 12/27/2022]
Abstract
Fifty years ago, Andreas Rett described a disorder in 22 females featuring prominent regression of fine motor and communication skills, cognitive impairment, stereotypic movements, periodic breathing, and gait abnormalities. This disorder became known as Rett syndrome (RTT) following the report of Hagberg et al. in 1983. Although RTT was scarcely recognized at that time in the United States, here the efforts of Rett and Hagberg led to rapid progress in recognition and diagnosis, a clearer understanding of its clinical and pathological underpinnings, and, ultimately, identification of mutations in the methyl-CpG-binding protein 2 (MECP2) gene as the primary cause of this unique and challenging neurodevelopmental disorder. Thereafter, a natural history study and critical translational research in animal models paved the way for potential disease-modifying agents to be assessed in human clinical trials. To be successful, the energies of the international community at all levels, including researchers in clinical and basic science, funding agencies, pharmaceutical companies, patient advocates, and, above all, parents and their children are essential. Otherwise, hopes for effective treatment, if not, a cure, will remain unfulfilled.
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Zappella M, Einspieler C, Bartl-Pokorny KD, Krieber M, Coleman M, Bölte S, Marschik PB. What do home videos tell us about early motor and socio-communicative behaviours in children with autistic features during the second year of life--An exploratory study. Early Hum Dev 2015; 91:569-75. [PMID: 26246137 PMCID: PMC5951277 DOI: 10.1016/j.earlhumdev.2015.07.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Little is known about the first half year of life of individuals later diagnosed with autism spectrum disorders (ASD). There is even a complete lack of observations on the first 6 months of life of individuals with transient autistic behaviours who improved in their socio-communicative functions in the pre-school age. AIM To compare early development of individuals with transient autistic behaviours and those later diagnosed with ASD. STUDY DESIGN Exploratory study; retrospective home video analysis. SUBJECTS 18 males, videoed between birth and the age of 6 months (ten individuals later diagnosed with ASD; eight individuals who lost their autistic behaviours after the age of 3 and achieved age-adequate communicative abilities, albeit often accompanied by tics and attention deficit). METHOD The detailed video analysis focused on general movements (GMs), the concurrent motor repertoire, eye contact, responsive smiling, and pre-speech vocalisations. RESULTS Abnormal GMs were observed more frequently in infants later diagnosed with ASD, whereas all but one infant with transient autistic behaviours had normal GMs (p<0.05). Eye contact and responsive smiling were inconspicuous for all individuals. Cooing was not observable in six individuals across both groups. CONCLUSIONS GMs might be one of the markers which could assist the earlier identification of ASD. We recommend implementing the GM assessment in prospective studies on ASD.
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Affiliation(s)
| | - Christa Einspieler
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Graz, Austria.
| | - Katrin D Bartl-Pokorny
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Graz, Austria
| | - Magdalena Krieber
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Graz, Austria
| | - Mary Coleman
- Foundation for Autism Research, Inc., New York, NY, USA
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm County Council, Stockholm, Sweden
| | - Peter B Marschik
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Graz, Austria; Center of Neurodevelopmental Disorders (KIND), Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden
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