1
|
Jording M, Hartz A, Vogel DHV, Schulte-Rüther M, Vogeley K. Impaired recognition of interactive intentions in adults with autism spectrum disorder not attributable to differences in visual attention or coordination via eye contact and joint attention. Sci Rep 2024; 14:8297. [PMID: 38594289 PMCID: PMC11004189 DOI: 10.1038/s41598-024-58696-2] [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: 06/22/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
Altered nonverbal communication patterns especially with regard to gaze interactions are commonly reported for persons with autism spectrum disorder (ASD). In this study we investigate and differentiate for the first time the interplay of attention allocation, the establishment of shared focus (eye contact and joint attention) and the recognition of intentions in gaze interactions in adults with ASD compared to control persons. Participants interacted via gaze with a virtual character (VC), who they believed was controlled by another person. Participants were instructed to ascertain whether their partner was trying to interact with them. In fact, the VC was fully algorithm-controlled and showed either interactive or non-interactive gaze behavior. Participants with ASD were specifically impaired in ascertaining whether their partner was trying to interact with them or not as compared to participants without ASD whereas neither the allocation of attention nor the ability to establish a shared focus were affected. Thus, perception and production of gaze cues seem preserved while the evaluation of gaze cues appeared to be impaired. An additional exploratory analysis suggests that especially the interpretation of contingencies between the interactants' actions are altered in ASD and should be investigated more closely.
Collapse
Affiliation(s)
- Mathis Jording
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany.
- Department of Psychiatry, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Arne Hartz
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH, Aachen, Germany
| | - David H V Vogel
- Department of Psychiatry, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Schulte-Rüther
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine - University Hospital Heidelberg, Ruprechts-Karls University Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Georg-August University Göttingen, Göttingen, Germany
| | - Kai Vogeley
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany
- Department of Psychiatry, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
2
|
Chetcuti L, Varcin KJ, Boutrus M, Smith J, Bent CA, Whitehouse AJO, Hudry K. Feasibility of a 2-minute eye-tracking protocol to support the early identification of autism. Sci Rep 2024; 14:5117. [PMID: 38429348 PMCID: PMC10907367 DOI: 10.1038/s41598-024-55643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
We tested the potential for Gazefinder eye-tracking to support early autism identification, including feasible use with infants, and preliminary concurrent validity of trial-level gaze data against clinical assessment scores. We embedded the ~ 2-min 'Scene 1S4' protocol within a comprehensive clinical assessment for 54 consecutively-referred, clinically-indicated infants (prematurity-corrected age 9-14 months). Alongside % tracking rate as a broad indicator of feasible assessment/data capture, we report infant gaze data to pre-specified regions of interest (ROI) across four trial types and associations with scores on established clinical/behavioural tools. Most infants tolerated Gazefinder eye-tracking well, returning high overall % tracking rate. As a group, infants directed more gaze towards social vs. non-social (or more vs. less socially-salient) ROIs within trials. Behavioural autism features were correlated with increased gaze towards non-social/geometry (vs. social/people) scenes. No associations were found for gaze directed to ROIs within other stimulus types. Notably, there were no associations between developmental/cognitive ability or adaptive behaviour with gaze towards any ROI. Gazefinder assessment seems highly feasible with clinically-indicated infants, and the people vs. geometry stimuli show concurrent predictive validity for behavioural autism features. Aggregating data across the ~ 2-min autism identification protocol might plausibly offer greater utility than stimulus-level analysis alone.
Collapse
Affiliation(s)
- Lacey Chetcuti
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Kandice J Varcin
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Maryam Boutrus
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Jodie Smith
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Catherine A Bent
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | | | - Kristelle Hudry
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
| |
Collapse
|
3
|
Yoon CD, Xia Y, Terol AK, Meadan H, Lee JD. Correlation Between Gaze Behaviors and Social Communication Skills of Young Autistic Children: A Meta-Analysis of Eye-Tracking Studies. J Autism Dev Disord 2024:10.1007/s10803-024-06257-x. [PMID: 38400896 DOI: 10.1007/s10803-024-06257-x] [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] [Accepted: 01/17/2024] [Indexed: 02/26/2024]
Abstract
This meta-analysis examined correlations between eye-tracking measures of gaze behaviors manifested during dynamic salient social stimuli and behavioral assessment measures of social communication skills of young autistic children. We employed a multilevel model with random effects to perform three separate meta-analyses for correlation between social communication skills and (a) all gaze behaviors, (b) gaze duration, and (c) gaze transition. Subsequently, we performed meta-regression to assess the role of four moderators, including age, continuum of naturalness of stimuli, gaze metric, and area of interest, on correlation effect sizes that were heterogeneous at the population level. A total of 111 correlation coefficients from 17 studies for 1132 young autistic children or children with high-likelihood for autism (Mage range = 6-95 months) were included in this meta-analysis. The correlation effect sizes for all three meta-analyses were significant, supporting the relation between improved gaze behaviors and better social communication skills. In addition, age, gaze metric, and area of interest were significant moderators. This suggests the importance of identifying meaningful gaze behaviors related to social communication skills and the increasingly influential role of gaze behaviors in shaping social communication skills as young autistic children progress through the early childhood stage. The continuum of naturalness of stimuli, however, was revealed to trend towards having a significant moderating effect. Lastly, it is important to note the evidence of potential publication bias. Our findings are discussed in the context of early identification and intervention and unraveling the complex nature of autism.
Collapse
Affiliation(s)
- Christy D Yoon
- Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA.
| | - Yan Xia
- Department of Educational Psychology, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA
| | - Adriana Kaori Terol
- Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA
| | - Hedda Meadan
- Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA
| | - James D Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6901 Sand Point Way NE, Seattle, WA, 98115, USA
| |
Collapse
|
4
|
Alarifi H, Aldhalaan H, Hadjikhani N, Johnels JÅ, Alarifi J, Ascenso G, Alabdulaziz R. Machine learning for distinguishing saudi children with and without autism via eye-tracking data. Child Adolesc Psychiatry Ment Health 2023; 17:112. [PMID: 37777792 PMCID: PMC10544143 DOI: 10.1186/s13034-023-00662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/26/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Despite the prevalence of Autism Spectrum Disorder (ASD) globally, there's a knowledge gap pertaining to autism in Arabic nations. Recognizing the need for validated biomarkers for ASD, our study leverages eye-tracking technology to understand gaze patterns associated with ASD, focusing on joint attention (JA) and atypical gaze patterns during face perception. While previous studies typically evaluate a single eye-tracking metric, our research combines multiple metrics to capture the multidimensional nature of autism, focusing on dwell times on eyes, left facial side, and joint attention. METHODS We recorded data from 104 participants (41 neurotypical, mean age: 8.21 ± 4.12 years; 63 with ASD, mean age 8 ± 3.89 years). The data collection consisted of a series of visual stimuli of cartoon faces of humans and animals, presented to the participants in a controlled environment. During each stimulus, the eye movements of the participants were recorded and analyzed, extracting metrics such as time to first fixation and dwell time. We then used these data to train a number of machine learning classification algorithms, to determine if these biomarkers can be used to diagnose ASD. RESULTS We found no significant difference in eye-dwell time between autistic and control groups on human or animal eyes. However, autistic individuals focused less on the left side of both human and animal faces, indicating reduced left visual field (LVF) bias. They also showed slower response times and shorter dwell times on congruent objects during joint attention (JA) tasks, indicating diminished reflexive joint attention. No significant difference was found in time spent on incongruent objects during JA tasks. These results suggest potential eye-tracking biomarkers for autism. The best-performing algorithm was the random forest one, which achieved accuracy = 0.76 ± 0.08, precision = 0.78 ± 0.13, recall = 0.84 ± 0.07, and F1 = 0.80 ± 0.09. CONCLUSIONS Although the autism group displayed notable differences in reflexive joint attention and left visual field bias, the dwell time on eyes was not significantly different. Nevertheless, the machine algorithm model trained on these data proved effective at diagnosing ASD, showing the potential of these biomarkers. Our study shows promising results and opens up potential for further exploration in this under-researched geographical context.
Collapse
Affiliation(s)
- Hana Alarifi
- Autism Center, King Faisal Specialists Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.
| | - Hesham Aldhalaan
- Autism Center, King Faisal Specialists Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Nouchine Hadjikhani
- Neurolimbic Research, Harvard/MGH Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Jakob Åsberg Johnels
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
- Section of Speech and Language Pathology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Jhan Alarifi
- Autism Center, King Faisal Specialists Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Guido Ascenso
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Reem Alabdulaziz
- Autism Center, King Faisal Specialists Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
5
|
Fakheir Y, Khalil R. The effects of abnormal visual experience on neurodevelopmental disorders. Dev Psychobiol 2023; 65:e22408. [PMID: 37607893 DOI: 10.1002/dev.22408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/14/2023] [Accepted: 06/13/2023] [Indexed: 08/24/2023]
Abstract
Normal visual development is supported by intrinsic neurobiological mechanisms and by appropriate stimulation from the environment, both of which facilitate the maturation of visual functions. However, an offset of this balance can give rise to visual disorders. Therefore, understanding the factors that support normal vision during development and in the mature brain is important, as vision guides movement, enables social interaction, and allows children to recognize and understand their environment. In this paper, we review fundamental mechanisms that support the maturation of visual functions and discuss and draw links between the perceptual and neurobiological impairments in autism spectrum disorder (ASD) and schizophrenia. We aim to explore how this is evident in the case of ASD, and how perceptual and neurobiological deficits further degrade social ability. Furthermore, we describe the altered perceptual experience of those with schizophrenia and evaluate theories of the underlying neural deficits that alter perception.
Collapse
Affiliation(s)
- Yara Fakheir
- Department of Biology, Chemistry, and Environmental Sciences, American University of Sharjah, Sharjah, UAE
| | - Reem Khalil
- Department of Biology, Chemistry, and Environmental Sciences, American University of Sharjah, Sharjah, UAE
| |
Collapse
|
6
|
Wang H, Zhao X, Yu D. Nonlinear features of gaze behavior during joint attention in children with autism spectrum disorder. Autism Res 2023; 16:1786-1798. [PMID: 37530201 DOI: 10.1002/aur.3000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/16/2023] [Indexed: 08/03/2023]
Abstract
Since children with autism spectrum disorder (ASD) might exhibit a variety of aberrant response to joint attention (RJA) behaviors, there is growing interest in identifying robust, reliable and valid eye-tracking metrics for determining differences in RJA behaviors between typically developing (TD) children and those with ASD. Previous eye-tracking studies have not been deeply investigated nonlinear features of gaze time-series during RJA. As a main motivation, this study aimed to extract three nonlinear features (i.e., complexity, long-range correlation, and local instability) of gaze time-series during RJA in children with ASD, which can be measured by fractal dimension (FD), Hurst exponent (H), and largest Lyapunov exponent (LLE), respectively. To illustrate our idea, this study adopted a publicly accessible database, including eye-tracking data collected during RJA from 19 children with ASD (7.74 ± 2.73) and 30 TD children (8.02 ± 2.89), and conducted a battery of nonparametric analysis of covariance (ANCOVA), where gender was used as covariable. Findings showed that gaze time-series during RJA in autistic children may generally have greater FD but lower H than that in TD controls. This implies that children with ASD possess more complex and unpredictable gaze behaviors during RJA than TD children. Furthermore, nonlinear metrics outperformed traditional eye-tracking metrics in obtaining higher identification performance with an accuracy of 82% and an AUC value of 0.81, distinguishing the differences between successful and failed RJA trails, and predicting the severity of ASD symptoms. Findings might bring some new insights into the understanding of the impairments in RJA behaviors for children with ASD.
Collapse
Affiliation(s)
- Hongan Wang
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Xin Zhao
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongchuan Yu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
7
|
de Belen RA, Pincham H, Hodge A, Silove N, Sowmya A, Bednarz T, Eapen V. Eye-tracking correlates of response to joint attention in preschool children with autism spectrum disorder. BMC Psychiatry 2023; 23:211. [PMID: 36991383 PMCID: PMC10061704 DOI: 10.1186/s12888-023-04585-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 02/02/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND A number of differences in joint attention behaviour between children with autism spectrum disorder (ASD) and typically developing (TD) individuals have previously been documented. METHOD We use eye-tracking technology to assess response to joint attention (RJA) behaviours in 77 children aged 31 to 73 months. We conducted a repeated-measures analysis of variance to identify differences between groups. In addition, we analysed correlations between eye-tracking and clinical measures using Spearman's correlation. RESULTS The children diagnosed with ASD were less likely to follow gaze compared to TD children. Children with ASD were less accurate at gaze following when only eye gaze information was available, compared to when eye gaze with head movement was observed. Higher accuracy gaze-following profiles were associated with better early cognition and more adaptive behaviours in children with ASD. Less accurate gaze-following profiles were associated with more severe ASD symptomatology. CONCLUSION There are differences in RJA behaviours between ASD and TD preschool children. Several eye-tracking measures of RJA behaviours in preschool children were found to be associated with clinical measures for ASD diagnosis. This study also highlights the construct validity of using eye-tracking measures as potential biomarkers in the assessment and diagnosis of ASD in preschool children.
Collapse
Affiliation(s)
- Ryan Anthony de Belen
- School of Computer Science and Engineering, University of New South Wales, Sydney, New South Wales, Australia.
| | - Hannah Pincham
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Antoinette Hodge
- Children's Hospital Westmead, Sydney, New South Wales, Australia
| | - Natalie Silove
- Children's Hospital Westmead, Sydney, New South Wales, Australia
- School of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Arcot Sowmya
- School of Computer Science and Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Tomasz Bednarz
- School of Art & Design, University of New South Wales, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Academic Unit of Child Psychiatry South West Sydney, Ingham Institute, Liverpool Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
8
|
Martínez-Lorca M, Gómez Fernández D. Rendimiento de los estímulos visuales en el diagnóstico del TEA por Eye Tracking: Revisión Sistemática. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2023. [DOI: 10.5209/rlog.83937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
El eye-tracking es una herramienta diagnóstica que tiene como fin el estudio del comportamiento de la mirada a través del escaneo de ojos para observar el seguimiento ocular, cómo se distribuye la mirada y la precisión de los movimientos oculares. Este sistema se ha utilizado con niños/as del Trastorno del Espectro Autista. El objetivo de esta revisión sistemática ha sido analizar el rendimiento de los estímulos visuales en el diagnóstico del TEA por método eye tracking. Para ello, se siguió la metodología PRISMA, realizando una búsqueda en las bases de datos PubMed, Science Direct y Scopus, así como, Reseach Gate. Se seleccionaron 22 artículos que cumplían los criterios de inclusión con experimentos unifactoriales, experimentales factoriales y cuasiexperimentales. Todos los experimentos han tenido un grupo control compuesto de muestra con participantes con desarrollo normotípico y de un grupo de caso compuesto de muestra con participantes TEA. Esta revisión sintetiza en tres categorías en base a las características del estímulo usado en el diagnóstico (estímulos sociales, no sociales y por confrontación), el análisis del rendimiento de los estímulos visuales, de manera que los estímulos sociales y los estímulos por confrontación van a ser eficaces para establecer un diagnóstico preciso de TEA puesto que permiten realizar un cribado de ambos grupos y establecer un riesgo temprano del trastorno.
Collapse
|
9
|
Costanzo V, Narzisi A, Cerullo S, Crifaci G, Boncoddo M, Turi M, Apicella F, Tancredi R, Muratori F, Calderoni S, Billeci L. High-Risk Siblings without Autism: Insights from a Clinical and Eye-Tracking Study. J Pers Med 2022; 12:jpm12111789. [PMID: 36573785 PMCID: PMC9699372 DOI: 10.3390/jpm12111789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022] Open
Abstract
Joint attention (JA)-the human ability to coordinate our attention with that of other people-is impaired in the early stage of Autism Spectrum Disorder (ASD). However, little is known about the JA skills in the younger siblings of children with ASD who do not develop ASD at 36 months of age [high-risk (HR)-noASD]. In order to advance our understanding of this topic, a prospective multicenter observational study was conducted with three groups of toddlers (age range: 18-33 months): 17 with ASD, 19 with HR-noASD and 16 with typical development (TD). All subjects underwent a comprehensive clinical assessment and an eye-tracking experiment with pre-recorded stimuli in which the visual patterns during two tasks eliciting initiating joint attention (IJA) were measured. Specifically, fixations, transitions and alternating gaze were analyzed. Clinical evaluation revealed that HR-noASD subjects had lower non-verbal cognitive skills than TD children, while similar levels of restricted and repetitive behaviors and better social communication skills were detected in comparison with ASD children. Eye-tracking paradigms indicated that HR-noASD toddlers had visual patterns resembling TD in terms of target-object-to-face gaze alternations, while their looking behaviors were similar to ASD toddlers regarding not-target-object-to-face gaze alternations. This study indicated that high-risk, unaffected siblings displayed a shared profile of IJA-eye-tracking measures with both ASD patients and TD controls, providing new insights into the characterization of social attention in this group of toddlers.
Collapse
Affiliation(s)
- Valeria Costanzo
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Antonio Narzisi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Sonia Cerullo
- Child Psychopathology Unit, Scientific Institute IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini, 22040 Lecco, Italy
| | - Giulia Crifaci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), 56124 Pisa, Italy
| | - Maria Boncoddo
- Interdepartmental Program “Autism 0-90”, “G. Martino” University Hospital of Messina, 98100 Messina, Italy
| | - Marco Turi
- Stella Maris Mediterraneo Foundation, 85032 Chiaromonte, Italy
| | - Fabio Apicella
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Raffaella Tancredi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Correspondence: ; Tel./Fax: +39-050-886200
| | - Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), 56124 Pisa, Italy
| |
Collapse
|
10
|
Research-Based Intervention (RBI) for Autism Spectrum Disorder: Looking beyond Traditional Models and Outcome Measures for Clinical Trials. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030430. [PMID: 35327802 PMCID: PMC8947461 DOI: 10.3390/children9030430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023]
Abstract
The rising prevalence of Autism Spectrum Disorders (ASD) has led to a quickly increasing need for effective interventions. Several criteria and measures have been developed to critically assess these interventions with particular focus on the evaluation of the efficacy. Given the huge diversity of ASD symptoms and the different levels of severity across individuals, identifying a one size fits all intervention approach is challenging, and the question What works and for whom? Remains still unanswered. Why do we seem to be dragging our feet on this fundamental issue? The main aim of this paper is to answer this question through four non-alternative points. First, there are a scarce number of studies with a solid methodology. Secondly, most trials on intervention efficacy for ASD are designed exclusively in terms of behavioral outcomes. Thirdly, there is a reduced use of biologically oriented outcome measures. Fourthly, in most clinical trials, appropriate practices emerging from research evidence are not systematically applied. A strong effort to improve the methodology of clinical trials is mandatory for the future of autism research. The development of a research-based intervention (RBI) perspective aimed at better integrating: (a) evidence-based approaches; (b) more sensitive behavioral outcome measures; and (c) biomarkers, with the aim of increasing a more detailed clustering of phenotypes, may strongly improve our approach to a precision medicine.
Collapse
|
11
|
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: 16] [Impact Index Per Article: 8.0] [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.
Collapse
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.
| |
Collapse
|
12
|
Mundy P, Bullen J. The Bidirectional Social-Cognitive Mechanisms of the Social-Attention Symptoms of Autism. Front Psychiatry 2022; 12:752274. [PMID: 35173636 PMCID: PMC8841840 DOI: 10.3389/fpsyt.2021.752274] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Differences in social attention development begin to be apparent in the 6th to 12th month of development in children with Autism Spectrum Disorder (ASD) and theoretically reflect important elements of its neurodevelopmental endophenotype. This paper examines alternative conceptual views of these early social attention symptoms and hypotheses about the mechanisms involved in their development. One model emphasizes mechanism involved in the spontaneous allocation of attention to faces, or social orienting. Alternatively, another model emphasizes mechanisms involved in the coordination of attention with other people, or joint attention, and the socially bi-directional nature of its development. This model raises the possibility that atypical responses of children to the attention or the gaze of a social partner directed toward themselves may be as important in the development of social attention symptoms as differences in the development of social orienting. Another model holds that symptoms of social attention may be important to early development, but may not impact older individuals with ASD. The alterative model is that the social attention symptoms in infancy (social orienting and joint attention), and social cognitive symptoms in childhood and adulthood share common neurodevelopmental substrates. Therefore, differences in early social attention and later social cognition constitute a developmentally continuous axis of symptom presentation in ASD. However, symptoms in older individuals may be best measured with in vivo measures of efficiency of social attention and social cognition in social interactions rather than the accuracy of response on analog tests used in measures with younger children. Finally, a third model suggests that the social attention symptoms may not truly be a symptom of ASD. Rather, they may be best conceptualized as stemming from differences domain general attention and motivation mechanisms. The alternative argued for here that infant social attention symptoms meet all the criteria of a unique dimension of the phenotype of ASD and the bi-directional phenomena involved in social attention cannot be fully explained in terms of domain general aspects of attention development.
Collapse
Affiliation(s)
- Peter Mundy
- Department of Learning and Mind Sciences, School of Education, University of California, Davis, Davis, CA, United States
- Department of Psychiatry and Behavioral Science and The MIND Institute, UC Davis School of Medicine, Sacramento, CA, United States
| | - Jenifer Bullen
- Department of Human Development, School of Human Ecology, University of California, Davis, Davis, CA, United States
| |
Collapse
|
13
|
Development of a visual attention based decision support system for autism spectrum disorder screening. Int J Psychophysiol 2022; 173:69-81. [PMID: 35007668 DOI: 10.1016/j.ijpsycho.2022.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
Visual attention of young children with autism spectrum disorder (ASD) has been well documented in the literature for the past 20 years. In this study, we developed a Decision Support System (DSS) that uses machine learning (ML) techniques to identify young children with ASD from typically developing (TD) children. Study participants included 26 to 36 months old young children with ASD (n = 61) and TD children (n = 72). The results showed that the proposed DSS achieved up to 87.5% success rate in the early assessment of ASD in young children. Findings suggested that visual attention is a unique, promising biomarker for early assessment of ASD. Study results were discussed, and suggestions for future research were provided.
Collapse
|
14
|
Thorup E, Nyström P, Bölte S, Falck-Ytter T. What are you looking at? Gaze following with and without target objects in ASD and typical development. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1668-1680. [PMID: 34903076 PMCID: PMC9483193 DOI: 10.1177/13623613211061940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT During the first year of life, infants start to align their attention with that of other people. This ability is called joint attention and facilitates social learning and language development. Although children with autism spectrum disorder (ASD) are known to engage less in joint attention compared to other children, several experimental studies have shown that they follow other's gaze (a requirement for visual joint attention) to the same extent as other children. In this study, infants' eye movements were measured at age 10, 14, and 18 months while watching another person look in a certain direction. A target object was either present or absent in the direction of the other person's gaze. Some of the infants were at elevated likelihood of ASD, due to having an older autistic sibling. At age 3 years, infants were assessed for a diagnosis of ASD. Results showed that infants who met diagnostic criteria at 3 years followed gaze to the same extent as other infants. However, they then looked back at the model faster than typically developing infants when no target object was present. When a target object was present, there was no difference between groups. These results may be in line with the view that directly after gaze following, infants with later ASD are less influenced by other people's gaze when processing the common attentional focus. The study adds to our understanding of both the similarities and differences in looking behaviors between infants who later receive an ASD diagnosis and other infants.
Collapse
Affiliation(s)
| | | | - Sven Bölte
- Karolinska Institutet, Sweden.,Stockholm Health Care Services, Region Stockholm, Sweden.,Curtin University, Australia
| | - Terje Falck-Ytter
- Uppsala University, Sweden.,Karolinska Institutet, Sweden.,Stockholm Health Care Services, Region Stockholm, Sweden.,Swedish Collegium for Advanced Study, Sweden
| |
Collapse
|
15
|
Liu Q, Wang Q, Li X, Gong X, Luo X, Yin T, Liu J, Yi L. Social synchronization during joint attention in children with autism spectrum disorder. Autism Res 2021; 14:2120-2130. [PMID: 34105871 DOI: 10.1002/aur.2553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/21/2021] [Accepted: 05/28/2021] [Indexed: 11/11/2022]
Abstract
We explored the social synchronization of gaze-shift behaviors when responding to joint attention in children with autism spectrum disorder (ASD). Forty-one children aged 5 to 8 with ASD and 43 typically developing (TD) children watched a video to complete the response to joint attention (RJA) tasks, during which their gaze data were collected. The synchronization of gaze-shift behaviors between children and the female model in the video was measured with the cross-recurrence quantification analysis (CRQA). Ultimately, we discovered that children with ASD had the ability to synchronize their gaze shifts with the female model in the video during RJA tasks. Compared to the TD children, they displayed lower levels of synchronization and longer latency in this synchronized behavior. These findings provide a new avenue to deepen our understanding of the impairments of social interaction in children with ASD. Notably, the analytic method can be further applied to explore the social synchronization of numerous other social interactive behaviors in ASD. LAY SUMMARY: This study explored how autistic children synchronized their gazed shifts with others' gaze cues during joint attention. We found that compared to typical children, autistic children synchronized their gazed shifts less and needed more time to follow others' gaze. These findings provide a new avenue to deepen our understanding of the impairments of social interaction in children with ASD.
Collapse
Affiliation(s)
- Qinyi Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qiandong Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xue Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xiaoyun Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, National Clinical Research Center for Mental Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China
| | - Tingni Yin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Li Yi
- School of Psychological and Cognitive Sciences & Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.,IDG/McGovern Institute for Brain Research at PKU, Peking University, Beijing, China
| |
Collapse
|
16
|
Nie G, Ullal A, Zheng Z, Swanson AR, Weitlauf AS, Warren ZE, Sarkar N. An Immersive Computer-Mediated Caregiver-Child Interaction System for Young Children With Autism Spectrum Disorder. IEEE Trans Neural Syst Rehabil Eng 2021; 29:884-893. [PMID: 33945481 PMCID: PMC8189254 DOI: 10.1109/tnsre.2021.3077480] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Autism Spectrum Disorder (ASD) affects 1 in 54 children in the United States. A core social communication skill negatively impacted by ASD is joint attention (JA), which influences the development of language, cognitive, and social skills from infancy onward. Although several technology-based JA studies have shown potential, they primarily focus on response to joint attention (RJA). The other important component of JA, the initiation of joint attention (IJA), has received less attention from a technology-based intervention perspective. In this work, we present an immersive Computer-mediated Caregiver-Child Interaction (C3I) system to help children with ASD practice IJA skills. C3I is a novel computerized intervention system that integrates a caregiver in the teaching loop, thereby preserving the advantages of both human and computer-administered intervention. A feasibility study with 6 dyads (caregiver-child with ASD) was conducted. A near significant increase with medium effect size on IJA performance was observed. Meanwhile, physiology-based stress analysis showed that C3I did not increase stress of the caregivers over the course of the study. To the best of our knowledge, this is the first autonomous system designed for teaching IJA skills to children with ASD incorporating caregivers within the loop to enhance the potential for generalization in real-world.
Collapse
|
17
|
Stephenson LJ, Edwards SG, Bayliss AP. From Gaze Perception to Social Cognition: The Shared-Attention System. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 16:553-576. [PMID: 33567223 PMCID: PMC8114330 DOI: 10.1177/1745691620953773] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
When two people look at the same object in the environment and are aware of each other's attentional state, they find themselves in a shared-attention episode. This can occur through intentional or incidental signaling and, in either case, causes an exchange of information between the two parties about the environment and each other's mental states. In this article, we give an overview of what is known about the building blocks of shared attention (gaze perception and joint attention) and focus on bringing to bear new findings on the initiation of shared attention that complement knowledge about gaze following and incorporate new insights from research into the sense of agency. We also present a neurocognitive model, incorporating first-, second-, and third-order social cognitive processes (the shared-attention system, or SAS), building on previous models and approaches. The SAS model aims to encompass perceptual, cognitive, and affective processes that contribute to and follow on from the establishment of shared attention. These processes include fundamental components of social cognition such as reward, affective evaluation, agency, empathy, and theory of mind.
Collapse
|
18
|
Tan G, Xu K, Liu J, Liu H. A Trend on Autism Spectrum Disorder Research: Eye Tracking-EEG Correlative Analytics. IEEE Trans Cogn Dev Syst 2021. [DOI: 10.1109/tcds.2021.3102646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
19
|
Eye-Tracking in Infants and Young Children at Risk for Autism Spectrum Disorder: A Systematic Review of Visual Stimuli in Experimental Paradigms. J Autism Dev Disord 2020; 51:2578-2599. [DOI: 10.1007/s10803-020-04731-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
20
|
Carrozza C, Fabio RA. Dysfunctional perceptual antecedent can justify the social orienting deficit in autism spectrum disorder: an eye-tracking study. ADVANCES IN AUTISM 2020. [DOI: 10.1108/aia-03-2020-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Children with Autism Spectrum Disorder (ASD) show reduced attention to social stimuli. The reasons for these impairments are still being debated by researchers. The aim of this study is to analyse if reduced attention towards social stimuli is determined by initial underlying difficulties in the control of visual attention. Among the variables that could produce these difficulties, the authors considered geometric complexity and typology of geometric figures.
Design/methodology/approach
To test this hypothesis, in this paper, an eye-tracker paradigm was used for assessing visual exploration and recognition memory towards geometric figures (curved vs rectilinear) with two levels of geometric complexity (low and high) in 17 children with ASD matched with 17 children with typical development (TD).
Findings
The results showed that the ASD group seemed indifferent to both the geometric complexity and the typology of figures (curved and rectilinear), whereas the TD group showed higher performances with highly complex and curved geometric figures than with low complex and rectilinear geometric figures.
Research limitations/implications
Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed hypotheses further.
Practical implications
This paper includes implications upon the presence of an unspecified visual attention deficit that is present from the early stages of the processing of stimuli.
Social implications
The understanding of this deficit from the early stages of the processing of stimuli can help educators to intervene at an early stage when disturbances in social relationships are starting.
Originality/value
This study contributes to understanding the presence of dysfunctional perceptual antecedents that could determine general difficulties in paying attention to social stimuli in ASD subjects.
Collapse
|
21
|
Doyle FL, Mendoza Diaz A, Eapen V, Frick PJ, Kimonis ER, Hawes DJ, Moul C, Richmond JL, Mehta D, Sareen S, Morgan BG, Dadds MR. Mapping the Specific Pathways to Early-Onset Mental Health Disorders: The "Watch Me Grow for REAL" Study Protocol. Front Psychiatry 2020; 11:553. [PMID: 32636770 PMCID: PMC7319093 DOI: 10.3389/fpsyt.2020.00553] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND From birth, the human propensity to selectively attend and respond to critical super-stimuli forms the basis of future socio-emotional development and health. In particular, the first super-stimuli to preferentially engage and elicit responses in the healthy newborn are the physical touch, voice and face/eyes of caregivers. From this grows selective attention and responsiveness to emotional expression, scaffolding the development of empathy, social cognition, and other higher human capacities. In this paper, the protocol for a longitudinal, prospective birth-cohort study is presented. The major aim of this study is to map the emergence of individual differences and disturbances in the system of social-Responsiveness, Emotional Attention, and Learning (REAL) through the first 3 years of life to predict the specific emergence of the major childhood mental health problems, as well as social adjustment and impairment more generally. A further aim of this study is to examine how the REAL variables interact with the quality of environment/caregiver interactions. METHODS/DESIGN A prospective, longitudinal birth-cohort study will be conducted. Data will be collected from four assessments and mothers' electronic medical records. DISCUSSION This study will be the first to test a clear developmental map of both the unique and specific causes of childhood psychopathology and will identify more precise early intervention targets for children with complex comorbid conditions.
Collapse
Affiliation(s)
- Frances L. Doyle
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Antonio Mendoza Diaz
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Valsamma Eapen
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Paul J. Frick
- Institute for Learning Sciences & Teacher Education, Australian Catholic University, Brisbane, QLD, Australia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Eva R. Kimonis
- Faculty of Science, School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - David J. Hawes
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Caroline Moul
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Jenny L. Richmond
- Faculty of Science, School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Divya Mehta
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sinia Sareen
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Bronte G. Morgan
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Mark R. Dadds
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
22
|
Braithwaite EK, Gui A, Jones EJH. Social attention: What is it, how can we measure it, and what can it tell us about autism and ADHD? PROGRESS IN BRAIN RESEARCH 2020; 254:271-303. [PMID: 32859292 DOI: 10.1016/bs.pbr.2020.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Neurodevelopmental disorders like autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) affect 2-10% of children worldwide but are still poorly understood. Prospective studies of infants with an elevated familial likelihood of ASD or ADHD can provide insight into early mechanisms that canalize development down a typical or atypical course. Such work holds potential for earlier identification and intervention to support optimal outcomes in individuals with neurodevelopmental disorders. Disrupted attention may be involved in developmental trajectories to ASD and ADHD. Specifically, altered attention to social stimuli has been suggested as a possible endophenotype of ASD, lying between genetic factors impacting brain development and later symptoms. Similarly, changes in domain-general aspects of attention are commonly seen in ADHD and emerging evidence suggests these may begin in infancy. Could these patterns point to a common risk factor for both disorders? Or does social attention reflect the activity of a particular network of brain systems that is distinct to those underpinning general attention skills? One challenge to addressing such questions is our lack of understanding of the relation between social and general attention. In this chapter we review evidence from infants with later ASD and ADHD that illuminates this question.
Collapse
Affiliation(s)
- Eleanor K Braithwaite
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - Anna Gui
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - Emily J H Jones
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom.
| |
Collapse
|
23
|
Jyoti V, Lahiri U. Human-Computer Interaction based Joint Attention cues: Implications on functional and physiological measures for children with autism spectrum disorder. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2019.106163] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
24
|
Are early visual behavior impairments involved in the onset of autism spectrum disorders? Insights for early diagnosis and intervention. Eur J Pediatr 2020; 179:225-234. [PMID: 31901981 DOI: 10.1007/s00431-019-03562-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/18/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
A correct use of the visual behavior (VB), and its integration with motor function, represents the earliest mean used by infants to explore and act on the social and non-social surrounding environment. The aim of this mini review is to present influential evidence of abnormalities in the VB domain in ASD individuals and to discuss the implication of these findings for early identification and intervention. We analyzed the possible anomalies in oculomotor abilities, visual attention, and visual-motor integration, as parts of a wider visual behavior defect, that could affect children with autism spectrum disorders (ASD) since the early stages of development.Conclusion: According to the literature, difficulties in these three areas have been often reported in children with ASD, and the visual-perception deficit could have cascading effects on learning processes and on social development. Despite this evidence of atypical VB in ASD, their investigation is not yet included into diagnostic processes, and they are not yet considered a specific treatment target.What is Known:•Atypical social use of visual behavior is one the first symptoms in children with autism spectrum disorders•Individuals with autism spectrum disorders often show unusual visual exploration of the surrounding environmentWhat is New:•It is possible to hypothesize that early visual behavior abnormalities may affect experiences that permit learning processes and social and communicative development in infants•An early assessment of visual behavior, as a core symptom of ASD, might improve the diagnostic processes and might help to developing more individualized treatments.
Collapse
|
25
|
Ioannou C, Seernani D, Stefanou ME, Biscaldi-Schaefer M, Tebartz Van Elst L, Fleischhaker C, Boccignone G, Klein C. Social Visual Perception Under the Eye of Bayesian Theories in Autism Spectrum Disorder Using Advanced Modeling of Spatial and Temporal Parameters. Front Psychiatry 2020; 11:585149. [PMID: 33101094 PMCID: PMC7546363 DOI: 10.3389/fpsyt.2020.585149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/28/2020] [Indexed: 01/03/2023] Open
Abstract
Social interaction in individuals with Autism Spectrum Disorder (ASD) is characterized by qualitative impairments that highly impact quality of life. Bayesian theories in ASD frame an understanding of underlying mechanisms suggesting atypicalities in the evaluation of probabilistic links within the perceptual environment of the affected individual. To address these theories, the present study explores the applicability of an innovative Bayesian framework on social visual perception in ASD and demonstrates the use of gaze transitions between different parts of social scenes. We applied advanced analyses with Bayesian Hidden Markov Modeling (BHMM) to track gaze movements while presenting real-life scenes to typically developing (TD) children and adolescents (N = 25) and participants with ASD and Attention-Deficit/Hyperactivity Disorder (ASD+ADHD, N = 15) and ASD without comorbidity (ASD, N = 12). Regions of interest (ROIs) were generated by BHMM based both on spatial and temporal gaze behavior. Social visual perception was compared between groups using transition and fixation variables for social (faces, bodies) and non-social ROIs. Transition variables between faces, namely gaze transitions between faces and likelihood of linking faces, were reduced in the ASD+ADHD compared to TD participants. Fixation count to faces was also reduced in this group. The ASD group showed similar performance to TD in the studied variables. There was no difference between groups for non-social ROIs. Our study provides an innovative, interpretable example of applying Bayesian theories of social visual perception in ASD. BHMM analyses and gaze transitions have the potential to reveal fundamental social perception components in ASD, contributing thus to amelioration of social-skill interventions.
Collapse
Affiliation(s)
- Chara Ioannou
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Divya Seernani
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Maria Elena Stefanou
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Monica Biscaldi-Schaefer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz Van Elst
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Christian Fleischhaker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | | | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany.,Department of Child and Adoelscent Psychiatry, University Hospital Cologne, Cologne, North Rhine-Westphalia, Germany.,Department of Psychiatry, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
26
|
Muratori F, Billeci L, Calderoni S, Boncoddo M, Lattarulo C, Costanzo V, Turi M, Colombi C, Narzisi A. How Attention to Faces and Objects Changes Over Time in Toddlers with Autism Spectrum Disorders: Preliminary Evidence from An Eye Tracking Study. Brain Sci 2019; 9:E344. [PMID: 31783561 PMCID: PMC6955945 DOI: 10.3390/brainsci9120344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 11/16/2022] Open
Abstract
Further understanding of the longitudinal changes in visual pattern of toddlers with autism spectrum disorders (ASDs) is needed. We examined twelve 19 to 33-month-old toddlers at their first diagnosis (mean age: 25.1 months) and after six months (mean age: 31.7 months) during two initiating joint attention (IJA) tasks using eye tracking. Results were compared with the performance of age-matched typically developing (TD) toddlers evaluated at a single time-point. Autistic toddlers showed longitudinal changes in the visual sensory processing of the IJA tasks, approaching TD performance with an improvement in the ability to disengage and to explore the global space. Findings suggest the use of eye tracking technology as an objective, non-intrusive, adjunctive tool to measure outcomes in toddlers with ASD.
Collapse
Affiliation(s)
- Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56128 Calambrone, PI, Italy
| | - Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), 56128 Calambrone, PI, Italy;
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56128 Calambrone, PI, Italy
| | - Maria Boncoddo
- Programma Interdipartimentale “Autismo 0–90”, A.O.U. Policlinico G. Martino, 98124 Messina, ME, Italy;
| | - Caterina Lattarulo
- Stella Maris Mediterraneo Foundation, 85032 Chiaromonte, PZ, Italy; (C.L.); (M.T.)
| | - Valeria Costanzo
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
| | - Marco Turi
- Stella Maris Mediterraneo Foundation, 85032 Chiaromonte, PZ, Italy; (C.L.); (M.T.)
| | - Costanza Colombi
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA;
| | - Antonio Narzisi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
| |
Collapse
|
27
|
Thorup E, Nyström P, Gredebäck G, Bölte S, Falck-Ytter T. Reduced Alternating Gaze During Social Interaction in Infancy is Associated with Elevated Symptoms of Autism in Toddlerhood. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019. [PMID: 29527625 PMCID: PMC6133004 DOI: 10.1007/s10802-017-0388-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In typical development, infants often alternate their gaze between their interaction partners and interesting stimuli, increasing the probability of joint attention toward surrounding objects and creating opportunities for communication and learning. Children with Autism Spectrum Disorder (ASD) have been found to engage less in behaviors that can initiate joint attention compared to typically developing children, but the role of such atypicalities in the development of ASD during infancy is not fully understood. Here, using eye tracking technology in a live setting, we show that 10-month-olds at high familial risk for ASD engage less in alternating gaze during interaction with an adult compared to low risk infants. These differences could not be explained by low general social preference or slow visual disengagement, as the groups performed similarly in these respects. We also found that less alternating gaze at 10 months was associated with more social ASD symptoms and less showing and pointing at 18 months. These relations were similar in both the high risk and the low risk groups, and remained when controlling for general social preference and disengagement latencies. This study shows that atypicalities in alternating gaze in infants at high risk for ASD emerge already during the first 10 months of life - a finding with theoretical as well as potential practical implications.
Collapse
Affiliation(s)
- Emilia Thorup
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Pär Nyström
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Gustaf Gredebäck
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Sven Bölte
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Pediatric Neuropsychiatry Unit, Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden.,BUP Stockholm, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Terje Falck-Ytter
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Uppsala, Sweden.,Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Pediatric Neuropsychiatry Unit, Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden
| | | |
Collapse
|
28
|
Cilia F, Aubry A, Le Driant B, Bourdin B, Vandromme L. Visual Exploration of Dynamic or Static Joint Attention Bids in Children With Autism Syndrome Disorder. Front Psychol 2019; 10:2187. [PMID: 31649576 PMCID: PMC6794558 DOI: 10.3389/fpsyg.2019.02187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 09/11/2019] [Indexed: 11/16/2022] Open
Abstract
Eye-tracking studies have revealed a specific visual exploration style characterizing individuals with autism spectrum disorder (ASD). The aim of this study is to investigate the impact of stimulus type (static vs. dynamic) on visual exploration in children with ASD. Twenty-eight children with ASD, 28 children matched for developmental communication age, and 28 children matched for chronological age watched a video and a series of photos involving the same joint attention scene. For each stimulus, areas of interest (AOI) were determined based on Voronoi diagrams, which were defined around participants' fixation densities, defined by the mean shift algorithm. To analyze the eye-tracking data on visual exploration, we used a method for creating AOI a posteriori, based on participants' actual fixations. The results showed the value of both kinds of stimuli. The photos allowed for the identification of more precise AOI and showed similarities in exploration between ASD and typical children. On the other hand, video revealed that, among ASD children only, there are few differences in the way they look at the target depending on the deictic cue used. This raises questions regarding their understanding of a joint attention bid recorded on a video. Finally, whatever the stimulus, pointing seems to be the most important element for children looking at the target.
Collapse
Affiliation(s)
- Federica Cilia
- EA7273 Centre de Recherche en Psychologie Cognition, Psychisme et Organisations, Université de Picardie Jules Verne, Amiens, France
| | - Alexandre Aubry
- EA7489, Laboratoire Lorrain de Psychologie et de Neurosciences de la Dynamique des Comportements (2LPN), Institut National Supérieur du Professorat et de l'Éducation, Université de Lorraine, Nancy, France
| | - Barbara Le Driant
- EA7273 Centre de Recherche en Psychologie Cognition, Psychisme et Organisations, Université de Picardie Jules Verne, Amiens, France
| | - Beatrice Bourdin
- EA7273 Centre de Recherche en Psychologie Cognition, Psychisme et Organisations, Université de Picardie Jules Verne, Amiens, France
| | - Luc Vandromme
- EA 7516, Chirurgie et Extrémité Céphalique, Caractérisation Morphologique et Fonctionnelle, Université de Picardie Jules Verne, Amiens, France
| |
Collapse
|
29
|
Parsons JP, Bedford R, Jones EJH, Charman T, Johnson MH, Gliga T. Gaze Following and Attention to Objects in Infants at Familial Risk for ASD. Front Psychol 2019; 10:1799. [PMID: 31481909 PMCID: PMC6710391 DOI: 10.3389/fpsyg.2019.01799] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/19/2019] [Indexed: 12/12/2022] Open
Abstract
Reduced gaze following has been associated previously with lower language scores in children with autism spectrum disorder (ASD). Here, we use eye-tracking in a controlled experimental setting to investigate whether gaze following and attention distribution during a word learning task associate with later developmental and clinical outcomes in a population of infants at familial risk for ASD. Fifteen-month-old infants (n = 124; n = 101 with familial risk) watched an actress repeatedly gaze toward and label one of two objects present in front of her. We show that infants who later developed ASD followed gaze as frequently as typically developing peers but spent less time engaged with either object. Moreover, more time spent on faces and less on objects was associated with lower concurrent or later verbal abilities, but not with later symptom severity. No outcome group showed evidence for word learning. Thus, atypical distribution of attention rather than poor gaze following is a limiting factor for language development in infants at familial risk for ASD.
Collapse
Affiliation(s)
- Janet P. Parsons
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - Rachael Bedford
- Biostatistics Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Emily J. H. Jones
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Mark H. Johnson
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Teodora Gliga
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
- Department of Psychology, University of East Anglia, Norwich, United Kingdom
| |
Collapse
|
30
|
Rayson H, Bonaiuto JJ, Ferrari PF, Chakrabarti B, Murray L. Building blocks of joint attention: Early sensitivity to having one's own gaze followed. Dev Cogn Neurosci 2019; 37:100631. [PMID: 30970289 PMCID: PMC6556871 DOI: 10.1016/j.dcn.2019.100631] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/24/2018] [Accepted: 03/03/2019] [Indexed: 12/22/2022] Open
Abstract
Detecting when one's own gaze has been followed is a critical component of joint attention, but little is known about its development. To address this issue, we used electroencephalography (EEG) to record infant neural responses at 6.5 and 9.5 months during observation of an adult either turning to look at the same object as the infant (congruent actor), or turning to look at a different object (incongruent actor). We also used a preferential looking paradigm to investigate whether infants would demonstrate a preference for the congruent versus incongruent actor. Greater suppression of alpha band activity in the congruent compared to incongruent condition was revealed at both ages in central and parietal regions. However, the effect of congruency on alpha suppression was stronger at 9.5 months, and only at this age did infants demonstrate a preference towards looking at the congruent actor. Together, these results suggest that although infants are sensitive to others' gaze following from early on, important neural and behavioural developments occur between 6.5 and 9.5 months.
Collapse
Affiliation(s)
- Holly Rayson
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom; Institut des Sciences Cognitives - Marc Jeannerod, CNRS, Bron, France.
| | - James J Bonaiuto
- Institut des Sciences Cognitives - Marc Jeannerod, CNRS, Bron, France; Sobell Department for Motor Neuroscience and Movement Disorders, University College London, United Kingdom
| | - Pier F Ferrari
- Institut des Sciences Cognitives - Marc Jeannerod, CNRS, Bron, France
| | - Bhismadev Chakrabarti
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Lynne Murray
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom; Department of Psychology, Stellenbosch University, South Africa; Department of Psychology, University of Cape Town, South Africa
| |
Collapse
|
31
|
Howard PL, Zhang L, Benson V. What Can Eye Movements Tell Us about Subtle Cognitive Processing Differences in Autism? Vision (Basel) 2019; 3:E22. [PMID: 31735823 PMCID: PMC6802779 DOI: 10.3390/vision3020022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/15/2019] [Accepted: 05/18/2019] [Indexed: 01/06/2023] Open
Abstract
Autism spectrum disorder (ASD) is neurodevelopmental condition principally characterised by impairments in social interaction and communication, and repetitive behaviours and interests. This article reviews the eye movement studies designed to investigate the underlying sampling or processing differences that might account for the principal characteristics of autism. Following a brief summary of a previous review chapter by one of the authors of the current paper, a detailed review of eye movement studies investigating various aspects of processing in autism over the last decade will be presented. The literature will be organised into sections covering different cognitive components, including language and social communication and interaction studies. The aim of the review will be to show how eye movement studies provide a very useful on-line processing measure, allowing us to account for observed differences in behavioural data (accuracy and reaction times). The subtle processing differences that eye movement data reveal in both language and social processing have the potential to impact in the everyday communication domain in autism.
Collapse
Affiliation(s)
- Philippa L Howard
- Department of Psychology, Bournemouth University, Bournemouth BH12 5BB, UK
| | - Li Zhang
- Academy of Psychology and Behaviour, Tianjin Normal University, Tianjin 300074, China
| | - Valerie Benson
- School of Psychology, University of Central Lancashire, Preston PR1 2HE, UK
| |
Collapse
|
32
|
Billeci L, Tonacci A, Narzisi A, Manigrasso Z, Varanini M, Fulceri F, Lattarulo C, Calderoni S, Muratori F. Heart Rate Variability During a Joint Attention Task in Toddlers With Autism Spectrum Disorders. Front Physiol 2018; 9:467. [PMID: 29765335 PMCID: PMC5938714 DOI: 10.3389/fphys.2018.00467] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 04/13/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Autism Spectrum Disorders (ASD) are a heterogeneous group of neurodevelopmental disorders featuring early impairments in social domain, with autonomic nervous system (ANS) unbalance possibly representing a useful marker for such disturbances. Impairments in joint attention (JA) are one of the earliest markers of social deficits in ASD. In this study, we assessed the feasibility of using wearable technologies for characterizing the ANS response in ASD toddlers during the presentation of JA stimuli. Methods: Twenty ASD toddlers and 20 age- and gender-matched typically developed (TD) children were recorded at baseline and during a JA task through an unobtrusive chest strap for electrocardiography (ECG). Specific algorithms for feature extraction, including Heart Rate (HR), Standard Deviation of the Normal-to-Normal Intervals (SDNN), Coefficient of Variation (CV), pNN10 as well as low frequency (LF) and high frequency (HF), were applied to the ECG signal and a statistical comparison between the two groups was performed. Results: As regards the single phases, SDNN (p = 0.04) and CV (p = 0.021) were increased in ASD at baseline together with increased LF absolute power (p = 0.034). Moreover, CV remained higher in ASD during the task (p = 0.03). Considering the phase and group interaction, LF increased from baseline to task in TD group (p = 0.04) while it decreased in the ASD group (p = 0.04). Conclusions: The results of this study indicate the feasibility of characterizing the ANS response in ASD toddlers through a minimally obtrusive tool. Our analysis showed an increased SDNN and CV in toddlers with ASD particularly at baseline compared to TD and lower LF during the task. These findings could suggest the possibility of using the proposed approach for evaluating physiological correlates of JA response in young children with ASD.
Collapse
Affiliation(s)
- Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Antonio Narzisi
- IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy
| | - Zaira Manigrasso
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Maurizio Varanini
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Francesca Fulceri
- IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy
| | - Caterina Lattarulo
- Child Neuropsychiatry Unit, Hospital "Madonna delle Grazie", Matera, Italy
| | - Sara Calderoni
- IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Muratori
- IRCCS Stella Maris Foundation, Department of Developmental Neuroscience, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
33
|
Billeci L, Narzisi A, Tonacci A, Sbriscia-Fioretti B, Serasini L, Fulceri F, Apicella F, Sicca F, Calderoni S, Muratori F. An integrated EEG and eye-tracking approach for the study of responding and initiating joint attention in Autism Spectrum Disorders. Sci Rep 2017; 7:13560. [PMID: 29051506 PMCID: PMC5648821 DOI: 10.1038/s41598-017-13053-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/20/2017] [Indexed: 11/08/2022] Open
Abstract
Autism Spectrum Disorders (ASD) are characterised by impairment in joint attention (JA), which has two components: the response to JA and the initiation of JA. Literature suggests a correlation between JA and neural circuitries, although this link is still largely unexplored in ASD. In this pilot study, we aimed at investigating the neural correlates of responding and initiating JA in high-functioning children with ASD and evaluating the changes in brain function and visual pattern after six months of rehabilitative treatment using an integrated EEG/eye-tracking system. Our results showed that initiating and responding JA subtend both overlapping (i.e. frontal and temporal) and specialized (i.e. parietal for responding JA and occipital for initiating JA) neural circuitries. In addition, in a subgroup of subjects, we observed trends of changes in both brain activity and connectivity after rehabilitative treatment in both the two tasks, which were correlated with modifications in gaze measures. These preliminary results, if confirmed in a larger sample, suggest the feasibility of using the proposed multimodal approach to characterise JA-related brain circuitries and visual pattern in ASD individuals and to monitor longitudinal changes in response to rehabilitative intervention.
Collapse
Affiliation(s)
- Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy, Via Moruzzi 1, 56124, Pisa, Italy.
| | - Antonio Narzisi
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56018, Calambrone, (PI), Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy, Via Moruzzi 1, 56124, Pisa, Italy
| | | | - Luca Serasini
- Institute of Clinical Physiology, National Research Council of Italy, Via Moruzzi 1, 56124, Pisa, Italy
| | - Francesca Fulceri
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56018, Calambrone, (PI), Italy
| | - Fabio Apicella
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56018, Calambrone, (PI), Italy
| | - Federico Sicca
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56018, Calambrone, (PI), Italy
| | - Sara Calderoni
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56018, Calambrone, (PI), Italy
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi 10, 56126, Pisa, Italy
| | - Filippo Muratori
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56018, Calambrone, (PI), Italy
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi 10, 56126, Pisa, Italy
| |
Collapse
|
34
|
Retico A, Arezzini S, Bosco P, Calderoni S, Ciampa A, Coscetti S, Cuomo S, De Santis L, Fabiani D, Fantacci ME, Giuliano A, Mazzoni E, Mercatali P, Miscali G, Pardini M, Prosperi M, Romano F, Tamburini E, Tosetti M, Muratori F. ARIANNA: A research environment for neuroimaging studies in autism spectrum disorders. Comput Biol Med 2017; 87:1-7. [PMID: 28544911 DOI: 10.1016/j.compbiomed.2017.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/15/2017] [Accepted: 05/15/2017] [Indexed: 01/07/2023]
Abstract
The complexity and heterogeneity of Autism Spectrum Disorders (ASD) require the implementation of dedicated analysis techniques to obtain the maximum from the interrelationship among many variables that describe affected individuals, spanning from clinical phenotypic characterization and genetic profile to structural and functional brain images. The ARIANNA project has developed a collaborative interdisciplinary research environment that is easily accessible to the community of researchers working on ASD (https://arianna.pi.infn.it). The main goals of the project are: to analyze neuroimaging data acquired in multiple sites with multivariate approaches based on machine learning; to detect structural and functional brain characteristics that allow the distinguishing of individuals with ASD from control subjects; to identify neuroimaging-based criteria to stratify the population with ASD to support the future development of personalized treatments. Secure data handling and storage are guaranteed within the project, as well as the access to fast grid/cloud-based computational resources. This paper outlines the web-based architecture, the computing infrastructure and the collaborative analysis workflows at the basis of the ARIANNA interdisciplinary working environment. It also demonstrates the full functionality of the research platform. The availability of this innovative working environment for analyzing clinical and neuroimaging information of individuals with ASD is expected to support researchers in disentangling complex data thus facilitating their interpretation.
Collapse
Affiliation(s)
- Alessandra Retico
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy.
| | - Silvia Arezzini
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Paolo Bosco
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Sara Calderoni
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56128 Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alberto Ciampa
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Simone Coscetti
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Stefano Cuomo
- Institute of Legal Information Theory and Techniques (ITTIG) of the National Research Council, Via de' Barucci 20, 50127 Florence, Italy
| | | | - Dario Fabiani
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Maria Evelina Fantacci
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy; University of Pisa, Physics Department, Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Alessia Giuliano
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Enrico Mazzoni
- National Institute for Nuclear Physics (INFN), Largo Bruno Pontecorvo 3, 56127 Pisa, Italy
| | - Pietro Mercatali
- Institute of Legal Information Theory and Techniques (ITTIG) of the National Research Council, Via de' Barucci 20, 50127 Florence, Italy
| | | | | | | | - Francesco Romano
- Institute of Legal Information Theory and Techniques (ITTIG) of the National Research Council, Via de' Barucci 20, 50127 Florence, Italy
| | | | - Michela Tosetti
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56128 Pisa, Italy
| | - Filippo Muratori
- IRCCS Stella Maris Foundation, Viale del Tirreno 331, 56128 Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
35
|
Le pointage dans l’autisme : Évolution de la compréhension et de la production après 6 mois d’intervention précoce. ENFANCE 2016. [DOI: 10.4074/s0013754516004080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
36
|
Thommen É, Rossini E, Di Fulvio A, Rudelli N, Cattelan C, Zecchin M, Guidetti M. Le pointage dans l’autisme : Évolution de la compréhension et de la production après 6 mois d’intervention précoce. ENFANCE 2016. [DOI: 10.3917/enf1.164.0445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
37
|
Billeci L, Tonacci A, Tartarisco G, Narzisi A, Di Palma S, Corda D, Baldus G, Cruciani F, Anzalone SM, Calderoni S, Pioggia G, Muratori F. An Integrated Approach for the Monitoring of Brain and Autonomic Response of Children with Autism Spectrum Disorders during Treatment by Wearable Technologies. Front Neurosci 2016; 10:276. [PMID: 27445652 PMCID: PMC4914552 DOI: 10.3389/fnins.2016.00276] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 06/02/2016] [Indexed: 11/26/2022] Open
Abstract
Autism Spectrum Disorders (ASD) are associated with physiological abnormalities, which are likely to contribute to the core symptoms of the condition. Wearable technologies can provide data in a semi-naturalistic setting, overcoming the limitations given by the constrained situations in which physiological signals are usually acquired. In this study an integrated system based on wearable technologies for the acquisition and analysis of neurophysiological and autonomic parameters during treatment is proposed and an application on five children with ASD is presented. Signals were acquired during a therapeutic session based on an imitation protocol in ASD children. Data were analyzed with the aim of extracting quantitative EEG (QEEG) features from EEG signals as well as heart rate and heart rate variability (HRV) from ECG. The system allowed evidencing changes in neurophysiological and autonomic response from the state of disengagement to the state of engagement of the children, evidencing a cognitive involvement in the children in the tasks proposed. The high grade of acceptability of the monitoring platform is promising for further development and implementation of the tool. In particular if the results of this feasibility study would be confirmed in a larger sample of subjects, the system proposed could be adopted in more naturalistic paradigms that allow real world stimuli to be incorporated into EEG/psychophysiological studies for the monitoring of the effect of the treatment and for the implementation of more individualized therapeutic programs.
Collapse
Affiliation(s)
- Lucia Billeci
- Institute of Clinical Physiology, National Research Council of ItalyPisa, Italy; Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy Pisa, Italy
| | - Gennaro Tartarisco
- Institute of Applied Sciences and Intelligent Systems "Eduardo Caianiello", National Research Council of Italy Messina, Italy
| | - Antonio Narzisi
- Department of Developmental Neuroscience, IRCSS Stella Maris Foundation Pisa, Italy
| | - Simone Di Palma
- Department of Information Engineering, University of Pisa Pisa, Italy
| | | | | | | | - Salvatore M Anzalone
- Institute of Intelligent Systems and Robotics, University Pierre and Marie Curie Paris, France
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCSS Stella Maris Foundation Pisa, Italy
| | - Giovanni Pioggia
- Institute of Applied Sciences and Intelligent Systems "Eduardo Caianiello", National Research Council of Italy Messina, Italy
| | - Filippo Muratori
- Department of Clinical and Experimental Medicine, University of PisaPisa, Italy; Department of Developmental Neuroscience, IRCSS Stella Maris FoundationPisa, Italy
| | | |
Collapse
|