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Cha JH, Ryu S, Park M, Lim BC, Kim YJ, Moon JH. Developmental screening of neurodevelopmental disorders before age 6: a nationwide health screening program. Pediatr Res 2024:10.1038/s41390-024-03516-6. [PMID: 39261660 DOI: 10.1038/s41390-024-03516-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 08/05/2024] [Accepted: 08/12/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND We aimed to investigate the association between developmental screening before 24 months of age and neurodevelopmental disorders (NDDs) at 4-6 years of age. METHODS We included 922,899 newborn born between 2014 and 2016 registered in National Health Insurance Service (NHIS). Developmental screening was administered at 9-12 and 18-24 months old with the Korean Developmental Screening Test for Infants & Children (K-DST). Diagnoses of NDDs was based on the World Health Organization's International Classification of Diseases, Tenth Revision (ICD-10), provided by the NHIS database. RESULTS Among 637,277 individuals who underwent screening at 9-12 and 18-24 months, Screen-positivity (defined as summed score < -2 standard deviation) for gross motor domain at 9-12 months was significantly associated with the incidence of autism spectrum disorder (aHR, 2.24; 95% CI, 1.80-2.80) and cerebral palsy (aHR, 4.81; 95% CI, 3.62-6.38). Screening positive at language domain at 18-24 months old was associated with autism spectrum disorder (aHR 5.50; 95% CI, 4.31- 7.02) and developmental language disorder (aHR 8.67; 95% CI, 7.27-10.33) at 4-6 years of age. CONCLUSION Widespread nationwide implementation of screening programs before 24 months was effective in identifying NDDs at 4-6 years of age. Further strategies integrating with referral and intervention systems should be established. IMPACT We investigated the screening effect of nationwide developmental screening program on neurodevelopmental disorders using nationwide data. Gross motor delay during infancy was significant predictor of later neurodevelopmental disorders. Language, cognitive, and social delay before 24 months of age was associated with later autism spectrum disorders and developmental language disorders. Widespread nationwide implementation of screening programs before 24 months was effective in identifying NDDs at 4-6 years of age and should be encouraged.
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Affiliation(s)
- Jong Ho Cha
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Soorack Ryu
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea
| | - Minjung Park
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Byung Chan Lim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Yong Joo Kim
- Division of Pediatric Gastroenterology, Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jin-Hwa Moon
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea.
- Division of Pediatric Neurology, Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
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Iverson JM, Britsch ER, Schneider JL, Plate SN, Focaroli V, Taffoni F, Keller F. Reaching While Learning to Sit: Capturing the Kinematics of Co-Developing Skills at Home. Dev Psychobiol 2024; 66:e22527. [PMID: 38973217 PMCID: PMC11334774 DOI: 10.1002/dev.22527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 05/06/2024] [Accepted: 06/17/2024] [Indexed: 07/09/2024]
Abstract
This study examined the co-development of infant reaching and postural control across the transition to arms-free sitting at home. We observed infants with typical likelihood (TL; n = 24) and elevated likelihood (EL; n = 20) for autism at four biweekly sessions spanning the transition to arms-free sitting (infant age = 4.5-8 months at first session). At each session, infants sat on a pressure-sensitive mat with external support or independently, wore magneto-inertial sensors on both wrists, and reached for toys presented at midline. Analyses focused on characterizing and comparing control of sitting during reaching actions and standard kinematic metrics of reaching during Supported versus Independent Sitting. Although EL infants achieved arms-free sitting later than TL peers, there were no group differences on any measures. Across sessions, infants' control of the sitting posture during concurrent reaching movements improved in both contexts, though they were less stable as they reached when sitting independently compared to when sitting with support. A similar effect was apparent in the kinematics of reaches, with overall improvement over time, but evidence of poorer control in Independent relative to Supported Sitting. Taken together, these findings underscore the mutually influential and dynamic relations between emerging skills and well-established behaviors.
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Affiliation(s)
| | | | | | | | - Valentina Focaroli
- Department of Economic, Psychological and Communication Sciences, Università degli Studi Niccolò Cusano, Rome, Italy
| | - Fabrizio Taffoni
- Laboratory of Biomedical Robotics and Biomicrosystems, Università Campus Biomedico di Roma, Rome, Italy
| | - Flavio Keller
- Laboratory of Biomedical Robotics and Biomicrosystems, Università Campus Biomedico di Roma, Rome, Italy
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Bowler A, Arichi T, Austerberry C, Fearon P, Ronald A. A systematic review and meta-analysis of the associations between motor milestone timing and motor development in neurodevelopmental conditions. Neurosci Biobehav Rev 2024; 167:105825. [PMID: 39067834 DOI: 10.1016/j.neubiorev.2024.105825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/16/2024] [Accepted: 07/21/2024] [Indexed: 07/30/2024]
Abstract
Early motor skills may be important early markers of neurodevelopmental conditions or predictors of their later onset. To explore this, we conducted a systematic review and meta-analysis of infant motor skill assessments in those who go on to gain a clinical diagnosis of autism, attention deficit hyperactivity disorder (ADHD), schizophrenia, language conditions, tic disorders, or developmental coordination disorder (DCD). In total, 63 articles met inclusion criteria. Three three-level meta-analyses were run. Meta-analysis of milestone achievement in N= 21205 individuals revealed gross motor milestones were significantly delayed compared to controls (g= 0.53, p< 0.001). Subgroup analyses revealed autism (g= 0.63) and DCD (g= 0.53) had the highest magnitude delays. Specific delays were revealed for holding the head up (g= 0.21), sitting (g= 0.28), standing (g= 0.35), crawling (g= 0.19), and walking (g= 0.71). Meta-analyses of standardised motor skill measurements in N= 1976 individuals revealed reduced performance compared to controls in autism and language conditions (g= -0.54, p< 0.001). Together, these findings demonstrate delayed milestone attainment and motor impairments in early childhood in neurodevelopmental conditions.
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Affiliation(s)
- Aislinn Bowler
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK; Social, Genetic and Developmental Psychiatry, King's College London, London, UK.
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK; Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK; MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Chloe Austerberry
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Pasco Fearon
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK; School of Psychology, University of Surrey, Guildford, UK
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Focaroli V, Taffoni F, Velardi A, Caravale B, Keller F. Object Exploration and Manipulation in Infants at Typical vs. Elevated Likelihood for ASD: A Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:825. [PMID: 39062274 PMCID: PMC11276247 DOI: 10.3390/children11070825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024]
Abstract
The present review considers the growing body of literature on fine motor skills in infants at elevated genetic likelihood (EL) for autism spectrum disorder (ASD). This area of study aims to identify crucial motor markers associated with the disorder, facilitating earlier and more accurate identification of ASD, using various experimental methodologies, including standardized assessments, observational measures, and technological tools. The reviewed evidence revealed distinct developmental trajectories in EL infants, marked by differences in fine motor skills and exploratory behaviors compared to typically developing infants. We discuss the developmental trajectory of fine motor skills in infants and their predictive value for later ASD diagnosis, highlighting the significance of fine motor skills as early indicators of ASD risk in infants and emphasizing the need for further research to elucidate their predictive value and underlying mechanisms.
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Affiliation(s)
- Valentina Focaroli
- Department of Economic, Psychological and Communication Sciences, Niccolò Cusano University, 00166 Rome, Italy
| | - Fabrizio Taffoni
- CREO LAB, Advanced Robotics and Human Centred-Technologies Laboratory, Campus Bio-Medico University, 00128 Rome, Italy;
| | - Andrea Velardi
- Department of Humanities, Motor Sciences and Education, Niccolò Cusano University, 00166 Rome, Italy;
| | - Barbara Caravale
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy;
| | - Flavio Keller
- Laboratory of Developmental Neuroscience, Campus Bio-Medico University, 00128 Rome, Italy;
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Flanagan JE, Demchick BB, Landa R, Delany JV, Reinoso G. Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder. Am J Occup Ther 2024; 78:7804185050. [PMID: 38768096 PMCID: PMC11220781 DOI: 10.5014/ajot.2024.050438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
IMPORTANCE Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis. OBJECTIVE To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns. DESIGN Observational cohort longitudinal design using blinded video analysis. PARTICIPANTS Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age. RESULTS Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = -2.29, p < .05, r = .31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD. CONCLUSIONS AND RELEVANCE Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD.
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Affiliation(s)
- Joanne E Flanagan
- Joanne E. Flanagan, ScD, OTR/L, is Associate Professor, Department of Occupational Therapy, Dr. Pallavi Patel College of Health Care Sciences, Nova Southeastern University, Clearwater, FL;
| | - Barbara B Demchick
- Barbara B. Demchick, ScD, OTR/L, FAOTA, is Professor Emerita, Department of Occupational Therapy and Occupational Science, Towson University, Baltimore, MD
| | - Rebecca Landa
- Rebecca Landa, PhD, is Executive Director, Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, and Professor, Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Janet V Delany
- Janet V. Delany, DEd, is Professor Emerita, Towson University, Baltimore, MD
| | - Gustavo Reinoso
- Gustavo Reinoso, PhD, OTR/L, is Associate Professor, College of Pharmacy and Health Sciences, Drake University, Des Moines, IA
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Pisula E, Pisula W. Back to Actual Behavior - A Modest Proposal on the Example of Exploratory Behavior in Children on the Autism Spectrum. Integr Psychol Behav Sci 2024; 58:693-710. [PMID: 37462860 PMCID: PMC11052857 DOI: 10.1007/s12124-023-09763-2] [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] [Accepted: 03/22/2023] [Indexed: 04/29/2024]
Abstract
Autism spectrum is characterized by difficulties in social communication and interactions and limited, restricted patterns of behavior, interests, and activity. It is diagnosed and described on the basis of behavioral characteristics. Therefore, behavior research plays a critical role in better understanding the functioning of this group of children. Studies on their interests and curiosity take mainly the form of experiments on visual and object exploration. We argue that important aspects of behavior might be neglected within these studies and propose to refine the approach by incorporating the achievements of classic ethology, contemporary measurement and analytical tools, and the theory of integrative levels. We conclude with an outline of the proposed approach in a short list of major methodological postulates.
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Affiliation(s)
- Ewa Pisula
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
| | - Wojciech Pisula
- Institute of Psychology, PAS, Jaracza 1, 00-378, Warsaw, Poland.
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Simarro Gonzalez M, Ni G, Lam V, Demopoulos C. Beyond words: an investigation of fine motor skills and the verbal communication spectrum in autism. Front Psychiatry 2024; 15:1379307. [PMID: 38835552 PMCID: PMC11148429 DOI: 10.3389/fpsyt.2024.1379307] [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: 01/31/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction This study investigated the associations between fine motor skills and expressive verbal abilities in a group of 97 autistic participants (age 8-17, mean=12.41) and 46 typically developing youth (age 8-17, mean=12.48). Methods Participants completed assessments of motor and verbal communication skills, including finger tapping speed, grooved pegboard, grip strength, visual-motor integration tasks, and measures of speech and communication skills. ASD group performance on motor tests was compared to controls. Non-parametric tests were used to analyze group differences and correlations between motor and verbal communication skills. Based on prior research, we hypothesized that individuals on the autism spectrum would exhibit deficits in fine motor speed, dexterity, pencil motor control, but not manual motor strength. Additionally, we expected that impaired fine motor skills would be linked to poorer performance on standardized measures of verbal abilities. Results The results indicated that 80% of autistic participants demonstrated an impairment on at least one measure of motor skills, and as a group, they exhibited significantly poorer fine motor performance compared to the non-ASD group in dominant hand finger tapping speed, bilateral fine motor dexterity measured via the grooved pegboard task, and pencil motor coordination and visual-motor integration measured on the Beery-Buktenica Developmental Test of Visual-Motor Integration-Sixth Edition. Moreover, impaired fine motor skills were associated with poorer performance on standardized clinical measures of verbal abilities, including articulation errors, receptive and expressive language and vocabulary, rapid naming, oromotor sequencing, and parent reported functional communication skills and social communication symptoms. Discussion Overall,our findings suggest there is a high prevalence of fine motor impairments in ASD, and these impairments were associated with a range of verbal abilities. Further research is warranted to better understand the underlying mechanisms of these associations and develop targeted interventions to address both fine motor and verbal impairments in ASD.
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Affiliation(s)
- Marian Simarro Gonzalez
- Spoken Language Interest Group, Basque Centre on Cognition, Brain and Language, San Sebastian, Spain
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Gessica Ni
- Department of UCSF Epilepsy and Pediatric Brain Center, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, United States
- Department of Neurology and Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Valerie Lam
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Carly Demopoulos
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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Surgent O, Guerrero-Gonzalez J, Dean DC, Adluru N, Kirk GR, Kecskemeti SR, Alexander AL, Li JJ, Travers BG. Microstructural neural correlates of maximal grip strength in autistic children: the role of the cortico-cerebellar network and attention-deficit/hyperactivity disorder features. Front Integr Neurosci 2024; 18:1359099. [PMID: 38808069 PMCID: PMC11130426 DOI: 10.3389/fnint.2024.1359099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/24/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction Maximal grip strength, a measure of how much force a person's hand can generate when squeezing an object, may be an effective method for understanding potential neurobiological differences during motor tasks. Grip strength in autistic individuals may be of particular interest due to its unique developmental trajectory. While autism-specific differences in grip-brain relationships have been found in adult populations, it is possible that such differences in grip-brain relationships may be present at earlier ages when grip strength is behaviorally similar in autistic and non-autistic groups. Further, such neural differences may lead to the later emergence of diagnostic-group grip differences in adolescence. The present study sought to examine this possibility, while also examining if grip strength could elucidate the neuro-motor sources of phenotypic heterogeneity commonly observed within autism. Methods Using high resolution, multi-shell diffusion, and quantitative R1 relaxometry imaging, this study examined how variations in key sensorimotor-related white matter pathways of the proprioception input, lateral grasping, cortico-cerebellar, and corticospinal networks were associated with individual variations in grip strength in 68 autistic children and 70 non-autistic (neurotypical) children (6-11 years-old). Results In both groups, results indicated that stronger grip strength was associated with higher proprioceptive input, lateral grasping, and corticospinal (but not cortico-cerebellar modification) fractional anisotropy and R1, indirect measures concordant with stronger microstructural coherence and increased myelination. Diagnostic group differences in these grip-brain relationships were not observed, but the autistic group exhibited more variability particularly in the cortico-cerebellar modification indices. An examination into the variability within the autistic group revealed that attention-deficit/hyperactivity disorder (ADHD) features moderated the relationships between grip strength and both fractional anisotropy and R1 relaxometry in the premotor-primary motor tract of the lateral grasping network and the cortico-cerebellar network tracts. Specifically, in autistic children with elevated ADHD features (60% of the autistic group) stronger grip strength was related to higher fractional anisotropy and R1 of the cerebellar modification network (stronger microstructural coherence and more myelin), whereas the opposite relationship was observed in autistic children with reduced ADHD features. Discussion Together, this work suggests that while the foundational elements of grip strength are similar across school-aged autistic and non-autistic children, neural mechanisms of grip strength within autistic children may additionally depend on the presence of ADHD features. Specifically, stronger, more coherent connections of the cerebellar modification network, which is thought to play a role in refining and optimizing motor commands, may lead to stronger grip in children with more ADHD features, weaker grip in children with fewer ADHD features, and no difference in grip in non-autistic children. While future research is needed to understand if these findings extend to other motor tasks beyond grip strength, these results have implications for understanding the biological basis of neuromotor control in autistic children and emphasize the importance of assessing co-occurring conditions when evaluating brain-behavior relationships in autism.
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Affiliation(s)
- Olivia Surgent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, United States
| | - Jose Guerrero-Gonzalez
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Douglas C. Dean
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - Nagesh Adluru
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Gregory R. Kirk
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Andrew L. Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
| | - James J. Li
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Psychology Department, University of Wisconsin-Madison, Madison, WI, United States
| | - Brittany G. Travers
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
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Orhan BE, Uzunçayır D, Canlı U, Karaçam A, Özdemir AS, Popa C, Iconomescu TM, Talaghir LG. Finding Stability-A Case Report on the Benefits of Adapted Kata Training for Children with Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2024; 11:523. [PMID: 38790518 PMCID: PMC11119168 DOI: 10.3390/children11050523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the efficacy of an Adapted Kata Training Program (AKTP) in enhancing balance for a 10-year-old child with Autism Spectrum Disorder (ASD), employing a mixed-model approach for data collection. Over 12 weeks, the AKTP demonstrated significant improvements in the child's balance abilities, with an 11% increase in static balance, 8% in proprioceptive, 12% in horizontal, and 14% in vertical balance performance. These improvements persisted in a follow-up assessment after four weeks. Observations by the child's mother corroborated the above findings. Consequently, this research suggests the AKTP as a valuable non-pharmacological intervention to improve balance in children with ASD. However, further studies are necessary to validate these results and explore the impact on additional developmental domains, such as cognitive and motor skills.
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Affiliation(s)
- Bekir Erhan Orhan
- Faculty of Sport Science, Istanbul Aydın University, 34295 Istanbul, Türkiye
| | - Dilek Uzunçayır
- Institute of Educational Sciences, Anadolu University, 26470 Eskisehir, Türkiye;
| | - Umut Canlı
- School of Physical Education and Sports, Tekirdag Namik Kemal University, 59030 Tekirdag, Türkiye;
| | - Aydın Karaçam
- Faculty of Sports Sciences, Bandırma Onyedi Eylül University, 10250 Bandırma, Türkiye;
| | - Ali Selman Özdemir
- Faculty of Sports Sciences, Istanbul Topkapı University, 34087 Istanbul, Türkiye;
| | - Cristian Popa
- Faculty of Physical Educațion and Sport, Ovidius University from Constanța, 900527 Constanta, Romania;
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Nies KJ, Baldwin J, Kaur M. Early Motor Delays During the First 2 Years of Life in Autism Spectrum Disorder: A Scoping Review. Pediatr Phys Ther 2024; 36:19-35. [PMID: 37816166 DOI: 10.1097/pep.0000000000001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
PURPOSE To summarize and appraise the emerging evidence on early motor skills of infants later diagnosed with autism spectrum disorder (ASD), and the association of early motor delays to later ASD diagnosis/characteristics. METHODS A literature search was conducted for studies published from 2000 to 2023 on the motor skills of infants later diagnosed with ASD, followed by screening and data extraction. RESULTS Current evidence suggested presence of early motor deficits including poor anticipatory movements, postural control, and gross/fine motor skills during the first 2 years of ASD. However, there was variability among studies with regard to study sample and methodology. CONCLUSION Although motor deficits are evident in infants, it is unclear whether these are specific to ASD or a consequence of general developmental disorder. Future research is needed on the investigation of specificity and severity of early motor delays, which can potentially assist in early identification of ASD.
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Affiliation(s)
- Kara J Nies
- Physical Therapy Department (Dr Nies), Cambridge Public Schools, Cambridge, Massachusetts; Physical Therapy Program (Drs Baldwin and Kaur), MGH Institute of Health Professions, Charlestown, Massachusetts
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Anshu K, Nair AK, Srinath S, Laxmi TR. Altered Developmental Trajectory in Male and Female Rats in a Prenatal Valproic Acid Exposure Model of Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:4390-4411. [PMID: 35976506 DOI: 10.1007/s10803-022-05684-y] [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] [Accepted: 07/13/2022] [Indexed: 10/15/2022]
Abstract
Early motor and sensory developmental delays precede Autism Spectrum Disorder (ASD) diagnosis and may serve as early indicators of ASD. The literature on sensorimotor development in animal models is sparse, male centered, and has mixed findings. We characterized early development in a prenatal valproic acid (VPA) model of ASD and found sex-specific developmental delays in VPA rats. We created a developmental composite score combining 15 test readouts, yielding a reliable gestalt measure spanning physical, sensory, and motor development, that effectively discriminated between VPA and control groups. Considering the heterogeneity in ASD phenotype, the developmental composite offers a robust metric that can enable comparison across different animal models of ASD and can serve as an outcome measure for early intervention studies.
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Affiliation(s)
- Kumari Anshu
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Main Road, Bengaluru, Karnataka, 560029, India
- Waisman Center, University of Wisconsin-Madison, Madison, 53705, WI, USA
| | - Ajay Kumar Nair
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Main Road, Bengaluru, Karnataka, 560029, India
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, 53703, WI, USA
| | - Shoba Srinath
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Main Road, Bengaluru, Karnataka, 560029, India
| | - T Rao Laxmi
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Main Road, Bengaluru, Karnataka, 560029, India.
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Alhozyel E, Elbedour L, Balaum R, Meiri G, Michaelovski A, Dinstein I, Davidovitch N, Kerub O, Menashe I. Association Between Early Developmental Milestones and Autism Spectrum Disorder. Res Child Adolesc Psychopathol 2023; 51:1511-1520. [PMID: 37231233 DOI: 10.1007/s10802-023-01085-6] [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] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
Early diagnosis and treatment of autism spectrum disorder (ASD) has been shown to lead to better prognosis. Here, we examined the association of commonly measured early developmental milestones (DMs) with later diagnosis of ASD. We conducted a case-control study of 280 children with ASD (cases) and 560 typically developed children (controls) matched to cases by date of birth, sex, and ethnicity in a control/case ratio of 2:1. Both cases and controls were ascertained from all children whose development was monitored at mother-child health clinics (MCHCs) in southern Israel. DM failure rates during the first 18 months of life in three developmental categories (motor, social, and verbal) were compared between cases and controls. Conditional logistic regression models were used to assess the independent association of specific DMs with the risk of ASD, while adjusting for demographic and birth characteristics.Significant case-control differences in DM failure rates were observed as early as 3 months of age (p < 0.001), and these differences increased with age. Specifically, cases were 2.4 times more likely to fail ≥ 1 DM at 3 months (aOR = 2.39; 95%CI = 1.41-4.06), and 15.3 times more likely to fail ≥ 3 DMs at 18 months (aOR = 15.32; 95%CI = 7.75-30.28). The most notable DM-ASD association was observed for social DM failure at 9-12 months (aOR = 4.59; 95%CI = 2.59-8.13). Importantly, the sex or ethnicity of the participants did not affect these DM-ASD associations. Our findings highlight the potential role of DMs as early signs of ASD that could facilitate earlier referral and diagnosis of ASD.
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Affiliation(s)
- Einav Alhozyel
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Leena Elbedour
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rewaa Balaum
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Meiri
- Preschool Psychiatric Unit, Soroka University Medical Center, Beer-Sheva, Israel
- Azrieli National Center for Autism and Neurodevelopment Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Analya Michaelovski
- Azrieli National Center for Autism and Neurodevelopment Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Child Development Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Ilan Dinstein
- Azrieli National Center for Autism and Neurodevelopment Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Psychology and Brain and Cognition Departments, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Orly Kerub
- The Mother and Child Department, Ministry of Health, Beer-Sheva, Israel
| | - Idan Menashe
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- Azrieli National Center for Autism and Neurodevelopment Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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13
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Doi H, Furui A, Ueda R, Shimatani K, Yamamoto M, Sakurai K, Mori C, Tsuji T. Spatiotemporal patterns of spontaneous movement in neonates are significantly linked to risk of autism spectrum disorders at 18 months old. Sci Rep 2023; 13:13869. [PMID: 37620366 PMCID: PMC10449803 DOI: 10.1038/s41598-023-40368-2] [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: 04/13/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Infants make spontaneous movements from the prenatal period. Several studies indicate that an atypical pattern of body motion during infancy could be utilized as an early biomarker of autism spectrum disorders (ASD). However, to date, little is known about whether the body motion pattern in neonates is associated with ASD risk. The present study sought to clarify this point by examining, in a longitudinal design, the link between features of spontaneous movement at about two days after birth and ASD risk evaluated using the Modified Checklist for Autism in Toddlers by their caregivers at 18 months old. The body movement features were quantified by a recently developed markerless system of infant body motion analysis. Logistic regression analysis revealed that ASD risk at 18 months old is associated with the pattern of spontaneous movement at the neonatal stage. Further, logistic regression based on body movement features during sleep shows better performance in classifying high- and low-risk infants than during the awake state. These findings raise the possibility that early signs of ASD risk may emerge at a developmental stage far earlier than previously thought.
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Affiliation(s)
- Hirokazu Doi
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan.
- School of Science and Engineering, Kokushikan University, 4-28-1 Setagaya, Setagaya-ku, Tokyo, 154-8515, Japan.
- Department of Information and Management Systems Engineering, Nagaoka University of Technology, 1603-1 Kamitomioka, Nagaoka, Niigata, 940-2188, Japan.
| | - Akira Furui
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739-8527, Japan.
| | - Rena Ueda
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739-8527, Japan
| | - Koji Shimatani
- Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1, Gakuen-machi, Mihara, Hiroshima, 734-8558, Japan
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739-8527, Japan.
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14
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Malachowski LG, Huntley MA, Needham AW. Case report: An evaluation of early motor skills in an infant later diagnosed with autism. Front Psychiatry 2023; 14:1205532. [PMID: 37404715 PMCID: PMC10315836 DOI: 10.3389/fpsyt.2023.1205532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/29/2023] [Indexed: 07/06/2023] Open
Abstract
Researchers and clinicians are increasingly interested in understanding the etiology of autism spectrum disorder (ASD) and identifying behaviors that can provide opportunities for earlier detection and therefore earlier onset of intervention activities. One promising avenue of research lies in the early development of motor skills. The present study compares the motor and object exploration behaviors of an infant later diagnosed with ASD (T.I.) with the same skills in a control infant (C.I.). There were notable difference in fine motor skills by just 3 months of age, one of the earliest fine motor differences reported in the literature. In line with previous findings, T.I. and C.I. demonstrated different patterns of visual attention as early as 2.5 months of age. At later visits to the lab, T.I. engaged in unique problem-solving behaviors not demonstrated by the experimenter (i.e., emulation). Overall, findings suggest that infants later diagnosed with ASD may show differences in fine motor skills and visual attention to objects from the first months of life.
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Affiliation(s)
- Lauren G. Malachowski
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, United States
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15
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Odermatt SD, Möhring W, Grieder S, Grob A. Cognitive and Developmental Functions in Autistic and Non-Autistic Children and Adolescents: Evidence from the Intelligence and Development Scales-2. J Intell 2022; 10:jintelligence10040112. [PMID: 36412792 PMCID: PMC9680381 DOI: 10.3390/jintelligence10040112] [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: 10/10/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
Autistic individuals often show impairments in cognitive and developmental domains beyond the core symptoms of lower social communication skills and restricted repetitive behaviors. Consequently, the assessment of cognitive and developmental functions constitutes an essential part of the diagnostic evaluation. Yet, evidence on differential validity from intelligence and developmental tests, which are commonly used with autistic individuals, varies widely. In the current study, we investigated the cognitive (i.e., intelligence, executive functions) and developmental (i.e., psychomotor skills, social-emotional skills, basic skills, motivation and attitude, participation during testing) functions of autistic and non-autistic children and adolescents using the Intelligence and Development Scales-2 (IDS-2). We compared 43 autistic (Mage = 12.30 years) with 43 non-autistic (Mage = 12.51 years) participants who were matched for age, sex, and maternal education. Autistic participants showed significantly lower mean values in psychomotor skills, language skills, and the evaluation of participation during testing of the developmental functions compared to the control sample. Our findings highlight that autistic individuals show impairments particularly in motor and language skills using the IDS-2, which therefore merit consideration in autism treatment in addition to the core symptoms and the individuals' intellectual functioning. Moreover, our findings indicate that particularly motor skills might be rather neglected in autism diagnosis and may be worthy of receiving more attention. Nonsignificant group differences in social-emotional skills could have been due to compensatory effects of average cognitive abilities in our autistic sample.
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Affiliation(s)
- Salome D. Odermatt
- Department of Psychology, University of Basel, 4055 Basel, Switzerland
- Correspondence:
| | - Wenke Möhring
- Department of Psychology, University of Basel, 4055 Basel, Switzerland
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, 73525 Schwäbisch Gmünd, Germany
| | - Silvia Grieder
- Department of Psychology, University of Basel, 4055 Basel, Switzerland
| | - Alexander Grob
- Department of Psychology, University of Basel, 4055 Basel, Switzerland
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16
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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.
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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
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17
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Hau J, Baker A, Chaaban C, Kohli JS, Jao Keehn RJ, Linke AC, Mash LE, Wilkinson M, Kinnear MK, Müller RA, Carper RA. Reduced asymmetry of the hand knob area and decreased sensorimotor u-fiber connectivity in middle-aged adults with autism. Cortex 2022; 153:110-125. [PMID: 35640320 PMCID: PMC9988270 DOI: 10.1016/j.cortex.2022.04.004] [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: 07/16/2021] [Revised: 12/07/2021] [Accepted: 04/06/2022] [Indexed: 01/27/2023]
Abstract
Individuals with autism spectrum disorder (ASD) frequently present with impairments in motor skills (e.g., limb coordination, handwriting and balance), which are observed across the lifespan but remain largely untreated. Many adults with ASD may thus experience adverse motor outcomes in aging, when physical decline naturally occurs. The 'hand knob' of the sensorimotor cortex is an area that is critical for motor control of the fingers and hands. However, this region has received little attention in ASD research, especially in adults after midlife. The hand knob area of the precentral (PrChand) and postcentral (PoChand) gyri was semi-manually delineated in 49 right-handed adults (25 ASD, 24 typical comparison [TC] participants, aged 41-70 years). Using multimodal (T1-weighted, diffusion-weighted, and resting-state functional) MRI, we examined the morphology, ipsilateral connectivity and laterality of these regions. We also explored correlations between hand knob measures with motor skills and autism symptoms, and between structural and functional connectivity measures. Bayesian analyses indicated moderate evidence of group effects with greater right PrChand volume and reduced leftward laterality of PrChand and PoChand volume in the ASD relative to TC group. Furthermore, the right PoC-PrChand u-fibers showed increased mean diffusivity in the ASD group. In the ASD group, right u-fiber volume positively correlated with corresponding functional connectivity but did not survive multiple comparisons correction. Correlations of hand knob measures and behavior were observed in the ASD group but did not survive multiple comparisons correction. Our findings suggest that morphological laterality and u-fiber connectivity of the sensorimotor network, putatively involved in hand motor/premotor function, may be diminished in middle-aged adults with ASD, perhaps rendering them more vulnerable to motor decline in old age. The altered morphology may relate to atypical functional motor asymmetries found in ASD earlier in life, possibly reflecting altered functional asymmetries over time.
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Affiliation(s)
- Janice Hau
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Ashley Baker
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Chantal Chaaban
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Jiwandeep S Kohli
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - R Joanne Jao Keehn
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Annika C Linke
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Lisa E Mash
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Molly Wilkinson
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Mikaela K Kinnear
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Ralph-Axel Müller
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Ruth A Carper
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, USA.
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18
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Affiliation(s)
- Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italia
| | - Paola Visconti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italia; Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
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19
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Belteki Z, Lumbreras R, Fico K, Haman E, Junge C. The Vocabulary of Infants with an Elevated Likelihood and Diagnosis of Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Infant Language Studies Using the CDI and MSEL. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031469. [PMID: 35162492 PMCID: PMC8834732 DOI: 10.3390/ijerph19031469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/14/2022] [Accepted: 01/21/2022] [Indexed: 01/27/2023]
Abstract
Diagnoses of autism spectrum disorder (ASD) are typically accompanied by atypical language development, which can be noticeable even before diagnosis. The siblings of children diagnosed with ASD are at elevated likelihood for ASD diagnosis and have been shown to have higher prevalence rates than the general population. In this paper, we systematically reviewed studies looking at the vocabulary size and development of infants with autism. One inclusion criterion was that infants were grouped either pre-diagnostically as elevated or typical likelihood or post-diagnostically as ASD or without ASD. This review focused on studies that tested infants up to 24 months of age and that assessed vocabulary either via the parent-completed MacArthur–Bates Communicative Developmental Inventory (CDI) or the clinician-administered Mullen Scales of Early Learning (MSEL). Our systematic search yielded 76 studies. A meta-analysis was performed on these studies that compared the vocabulary scores of EL and TL infants pre-diagnostically and the scores of ASD and non-ASD infants post-diagnostically. Both pre- and post-diagnostically, it was found that the EL and ASD infants had smaller vocabularies than their TL and non-ASD peers, respectively. The effect sizes across studies were heterogenous, prompting additional moderator analyses of age and sub-group analyses of the language measure used (CDI or MSEL) as potential moderators of the effect size. Age was found to be a moderator both in the pre- and post-diagnostical groups, however, language measure was not a moderator in either diagnostic group. Interpretations and future research directions are discussed based on these findings.
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Affiliation(s)
- Zsofia Belteki
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands;
- Correspondence:
| | - Raquel Lumbreras
- Faculty of Medicine, Utrecht University, 3584 CS Utrecht, The Netherlands;
| | - Kloe Fico
- Donders Institute for Brain, Cognition and Behavior, Radboud University, 6525 XZ Nijmegen, The Netherlands;
| | - Ewa Haman
- Faculty of Psychology, University of Warsaw, 00-927 Warsaw, Poland;
| | - Caroline Junge
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands;
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20
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Hocking DR, Ardalan A, Abu-Rayya HM, Farhat H, Andoni A, Lenroot R, Kachnowski S. Feasibility of a virtual reality-based exercise intervention and low-cost motion tracking method for estimation of motor proficiency in youth with autism spectrum disorder. J Neuroeng Rehabil 2022; 19:1. [PMID: 34996473 PMCID: PMC8742363 DOI: 10.1186/s12984-021-00978-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background Motor impairment is widely acknowledged as a core feature in children with autism spectrum disorder (ASD), which can affect adaptive behavior and increase severity of symptoms. Low-cost motion capture and virtual reality (VR) game technologies hold a great deal of promise for providing personalized approaches to motor intervention in ASD. The present study explored the feasibility, acceptability and potential efficacy of a custom-designed VR game-based intervention (GaitWayXR™) for improving gross motor skills in youth with ASD. Methods Ten children and adolescents (10–17 years) completed six, 20-min VR-based motor training sessions over 2 weeks while whole-body movement was tracked with a low-cost motion capture system. We developed a methodology for using motion tracking data to quantify whole-body movement in terms of efficiency, synchrony and symmetry. We then studied the relationships of the above quantities with standardized measures of motor skill and cognitive flexibility. Results Our results supported our presumption that the VR intervention is safe, with no adverse events and very few minor to moderate side-effects, while a large proportion of parents said they would use the VR game at home, the most prohibitive reasons for adopting the system for home therapy were cost and space. Although there was little evidence of any benefits of the GaitWayXR™ intervention in improving gross motor skills, we showed several positive correlations between the standardized measures of gross motor skills in ASD and our measures of efficiency, symmetry and synchrony from low-cost motion capture. Conclusions These findings, though preliminary and limited by small sample size, suggest that low-cost motion capture of children with ASD is feasible with movement exercises in a VR-based game environment. Based on these preliminary findings, we recommend conducting larger-scale studies with methods for improving adherence to VR gaming interventions over longer periods.
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Affiliation(s)
- Darren R Hocking
- Developmental Neuromotor and Cognition Lab, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
| | - Adel Ardalan
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Hisham M Abu-Rayya
- School of Social Sciences and Humanities, Doha Institute for Graduate Studies, Doha, Qatar.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Hassan Farhat
- Developmental Neuromotor and Cognition Lab, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Anna Andoni
- HITLAB, Healthcare Innovation & Technology Lab, Columbia University, New York, NY, USA
| | - Rhoshel Lenroot
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Stan Kachnowski
- HITLAB, Healthcare Innovation & Technology Lab, Columbia University, New York, NY, USA
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21
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Ma CH, Chen LY, Li MF, Wu D, Wang SS, Zhao YJ, Shi JL, Rydell PJ, Chen JJ, Wang Y. Treatment of Preschool Children With Autism Spectrum Disorder: A Trial to Evaluate a Learning Style Profile Intervention Program in China. Front Pediatr 2022; 10:831621. [PMID: 35372141 PMCID: PMC8966376 DOI: 10.3389/fped.2022.831621] [Citation(s) in RCA: 1] [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: 12/08/2021] [Accepted: 02/22/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate whether the provision of learning style profile (LSP) training improves development in preschool children with autism spectrum disorder (ASD) in China and to describe the characteristics of children who benefit from the intervention. METHODS Eighty-one children aged 36 to 72 months who were diagnosed with ASD for the first time were recruited for the intervention group. All of them received 24 weeks of LSP training, consisting of hospital- and home-based training. Twenty-one children with ASD of the same age in the control group had never received any intervention after diagnosis but underwent an assessment. Assessments were conducted at baseline and 24 weeks later. Differences in the developmental level and severity of ASD symptoms over time and between groups were analyzed by repeated standardized measures. Secondary analyses examined age effects among the 36- 48-, 48- 60-, and 60-72-month age groups. RESULTS Within-group comparison of the intervention group revealed significant treatment effects after the intervention, according to: language, social and adaptive developmental quotients (DQs) of the China Developmental Scale; total Childhood Autism Rating Scale (CARS) score; and hyperactivity, peer problems, total difficulties, and prosocial behavior scores of the Strengths and Difficulties Questionnaire (SDQ). Similar gains were observed in gross and fine motor DQs of the China Developmental Scale and emotional symptoms and conduct problems scores of the SDQ; however, the differences between these pre- and postintervention scores did not reach statistical significance. Comparisons among the three age groups in the intervention groups demonstrated a significant age effect on adaptive DQs of the China Developmental Scale; total CARS score; hyperactivity, peer problems and total difficulties scores of the SDQ. Comparison between the intervention and control groups revealed significant treatment effects on language, social and adaptive DQs of the China Developmental Scale; total CARS score; and emotional symptoms, conduct problems, hyperactivity, peer problems, total difficulties, and prosocial behavior scores of the SDQ after the intervention. Similar gains were observed in gross and fine motor DQs of the China Developmental Scale, although differences between the two groups did not reach statistical significance. CONCLUSION Our findings suggest that LSP training can effectively improve social behavior and reduce the severity of ASD symptoms in children with ASD. Our data also highlight the importance of early intervention.
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Affiliation(s)
- Chen-Huan Ma
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ling-Yan Chen
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Meng-Fan Li
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Dan Wu
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Sha-Sha Wang
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yan-Jun Zhao
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jian-Li Shi
- Department of Molecular, Cellular and Developmental Biology, University of Colorado, Denver, CO, United States
| | - Patrick J Rydell
- Department of Communicative Disorders, University of Louisiana at Lafayette, Lafayette, LA, United States
| | - Jin-Jin Chen
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Wang
- Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
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22
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Carter M, Casey S, O'Keeffe GW, Gibson L, Gallagher L, Murray DM. Maternal Immune Activation and Interleukin 17A in the Pathogenesis of Autistic Spectrum Disorder and Why It Matters in the COVID-19 Era. Front Psychiatry 2022; 13:823096. [PMID: 35250672 PMCID: PMC8891512 DOI: 10.3389/fpsyt.2022.823096] [Citation(s) in RCA: 3] [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: 11/26/2021] [Accepted: 01/21/2022] [Indexed: 11/30/2022] Open
Abstract
Autism spectrum disorder (ASD) is the commonest neurodevelopmental disability. It is a highly complex disorder with an increasing prevalence and an unclear etiology. Consensus indicates that ASD arises as a genetically modulated, and environmentally influenced condition. Although pathogenic rare genetic variants are detected in around 20% of cases of ASD, no single factor is responsible for the vast majority of ASD cases or that explains their characteristic clinical heterogeneity. However, a growing body of evidence suggests that ASD susceptibility involves an interplay between genetic factors and environmental exposures. One such environmental exposure which has received significant attention in this regard is maternal immune activation (MIA) resulting from bacterial or viral infection during pregnancy. Reproducible rodent models of ASD are well-established whereby induction of MIA in pregnant dams, leads to offspring displaying neuroanatomical, functional, and behavioral changes analogous to those seen in ASD. Blockade of specific inflammatory cytokines such as interleukin-17A during gestation remediates many of these observed behavioral effects, suggesting a causative or contributory role. Here, we review the growing body of animal and human-based evidence indicating that interleukin-17A may mediate the observed effects of MIA on neurodevelopmental outcomes in the offspring. This is particularly important given the current corona virus disease-2019 (COVID-19) pandemic as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is a potent stimulator of the maternal immune response, however the long-term effects of maternal SARS-CoV-2 infection on neurodevelopmental outcomes is unclear. This underscores the importance of monitoring neurodevelopmental outcomes in children exposed to SARS-CoV-2-induced MIA during gestation.
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Affiliation(s)
- Michael Carter
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.,National Children's Research Centre, Dublin, Ireland
| | - Sophie Casey
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Gerard W O'Keeffe
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Louise Gibson
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Louise Gallagher
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Trinity Translational Medicine Institute, St. James's Hospital, Dublin, Ireland
| | - Deirdre M Murray
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
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23
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Chen Y, Fei X, Wu T, Li H, Xiong N, Shen R, Wang Y, Liang A, Wang H. The relationship between motor development and social adaptability in autism spectrum disorder. Front Psychiatry 2022; 13:1044848. [PMID: 36506435 PMCID: PMC9726915 DOI: 10.3389/fpsyt.2022.1044848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Autism spectrum disorders(ASD)describe a wide range of pervasive developmental disorders by core symptoms including deficits in social communication and interaction, as well as restricted, repetitive, and stereotyped behaviors. At the same time, some children with autism are accompanied by motor development disorder. Many studies have confirmed that the motor development impairment was significantly associated with the social problems associated with ASD. Thus, this study aimed to investigate how motor development affects social adaptability in children with ASD to provide references for early ASD intervention. MATERIALS AND METHODS The case data of children's health care were selected in 2021. Motor development was assessed with the Developmental Behavior Assessment Scale for Children Aged 0-6 years. Social adaptability was measured using the Japanese S-M Social Living Skills Scale. Statistical analysis was conducted with SPSS 22.0 software package. Data were analyzed using independent samples t-test and logistic regression. RESULTS A total of 198 cases comprising 140 boys (70.71%) and 58 girls (29.29%) were included, and the average age of participants was 3.40 ± 1.06 years, with 3.33 ± 1.18 years in the typical development (TD) children group and 3.46 ± 0.95 years in the ASD group. The social adaptability of 107 ASD children was abnormal, including 37 children (34.5%) with marginal, 48 children (44.9%) with mild, 17 children (15.9%) with moderate, and 5 children (4.7%) with severe. In 91 TD children, there were 51 children (56.04%) with normal social adaptability, 38 children (41.75%) with marginal, 2 children (2.19%) with mild, and nobody with moderate or severe. The ASD children had lower levels of developmental behavior than those of TD children, and the difference was statistically significant. The results of logistic regression showed that fine motor increased by 1 unit, and the OR value of one level decreased in social adaptability was 2.24 times (OR = e0.807 = 2.24). CONCLUSION In children with ASD, not only motor development is delayed, but also social adaptability is affected, and fine motor skill may be important for social adaptability.
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Affiliation(s)
- YanJie Chen
- Department of Children's Health Care Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xi Fei
- School of Sports Science, Beijing Sport University, Beijing, China
| | - TianChen Wu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - HongJuan Li
- School of Sports Science, Beijing Sport University, Beijing, China
| | - NiNa Xiong
- Department of Children's Health Care Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - RuiYun Shen
- Department of Children's Health Care Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ying Wang
- Department of Children's Health Care Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - AiMin Liang
- Department of Children's Health Care Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Huan Wang
- China Institute of Sport Science, Beijing, China
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24
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Wang LAL, Petrulla V, Zampella CJ, Waller R, Schultz RT. Gross motor impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses. Psychol Bull 2022; 148:273-300. [PMID: 35511567 PMCID: PMC9894569 DOI: 10.1037/bul0000358] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Gross motor ability is associated with profound differences in how children experience and interact with their social world. A rapidly growing literature on motor development in autism spectrum disorder (ASD) indicates that autistic individuals exhibit impairment in gross motor skills. However, due to substantial heterogeneity across studies, it remains unclear which gross motor skills are impaired in ASD, when and for whom these differences emerge, and whether motor and social impairments are related. The present article addressed these questions by synthesizing research on gross motor skills in ASD in two separate meta-analyses. The first examined gross motor deficits in ASD compared to neurotypical (NT) controls, aggregating data from 114 studies representing 6,423 autistic and 2,941 NT individuals. Results demonstrated a significant overall deficit in gross motor skills in ASD (Hedges' g = -1.04) that was robust to methodological and phenotypic variation and was significant at every level of the tested moderators. However, moderation analyses revealed that this deficit was most pronounced for object control skills (i.e., ball skills), clinical assessment measures, and movements of the upper extremities or the whole body. The second meta-analysis investigated whether gross motor and social skills are related in ASD, synthesizing data from 21 studies representing 654 autistic individuals. Findings revealed a modest but significant overall correlation between gross motor and social skills in ASD (r = 0.27). Collectively, results support the conclusion that motor deficits are tied to the core symptoms of ASD. Further research is needed to test the causality and directionality of this relationship. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Leah A. L. Wang
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States,Department of Psychology, University of Pennsylvania
| | | | - Casey J. Zampella
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | | | - Robert T. Schultz
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States,Department of Psychology, University of Pennsylvania,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania
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25
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Reynolds JE, Whitehouse AJO, Alvares GA, Waddington H, Macaskill E, Licari MK. Characterising the Early Presentation of Motor Difficulties in Autistic Children. J Autism Dev Disord 2021; 52:4739-4749. [PMID: 34739646 DOI: 10.1007/s10803-021-05333-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 10/19/2022]
Abstract
This study aimed to explore the rates of motor difficulties in children from the Australian Autism Biobank, and how early motor concerns impacted on children functionally. Children with autism aged 2-7 years, including 441 with a Vineland Adaptive Behavior Scale (VABS-II) motor subscale and 385 with a Mullen Scales of Early Learning (MSEL) fine motor subscale were included (n total = 514; 80% male). Approximately 60% of children on the MSEL and ~ 25% on the VABS-II had clinically significant motor impairments. More children with delayed sitting and walking motor milestones had early childhood parent reported motor difficulties (p < 0.001). Early motor delays or concerns may assist identifying individuals who will likely benefit from early ongoing developmental monitoring and early support.
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Affiliation(s)
- Jess E Reynolds
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
| | | | - Gail A Alvares
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Hannah Waddington
- School of Education, Faculty of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Ella Macaskill
- School of Psychology, Faculty of Science, Victoria University of Wellington, Wellington, New Zealand
| | - Melissa K Licari
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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26
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Grzadzinski R, Amso D, Landa R, Watson L, Guralnick M, Zwaigenbaum L, Deák G, Estes A, Brian J, Bath K, Elison J, Abbeduto L, Wolff J, Piven J. Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda. J Neurodev Disord 2021; 13:49. [PMID: 34654371 PMCID: PMC8520312 DOI: 10.1186/s11689-021-09393-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/16/2021] [Indexed: 12/26/2022] Open
Abstract
Autism spectrum disorder (ASD) impacts an individual's ability to socialize, communicate, and interact with, and adapt to, the environment. Over the last two decades, research has focused on early identification of ASD with significant progress being made in understanding the early behavioral and biological markers that precede a diagnosis, providing a catalyst for pre-symptomatic identification and intervention. Evidence from preclinical trials suggest that intervention prior to the onset of ASD symptoms may yield more improved developmental outcomes, and clinical studies suggest that the earlier intervention is administered, the better the outcomes. This article brings together a multidisciplinary group of experts to develop a conceptual framework for behavioral intervention, during the pre-symptomatic period prior to the consolidation of symptoms into diagnosis, in infants at very-high-likelihood for developing ASD (VHL-ASD). The overarching goals of this paper are to promote the development of new intervention approaches, empirical research, and policy efforts aimed at VHL-ASD infants during the pre-symptomatic period (i.e., prior to the consolidation of the defining features of ASD).
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Affiliation(s)
- Rebecca Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA.
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA.
| | - Dima Amso
- Department of Psychology, Columbia University, New York, NY, USA
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Linda Watson
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA
- Division of Speech and Hearing Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Michael Guralnick
- Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | | | - Gedeon Deák
- Department of Cognitive Science, University of California, San Diego, San Diego, CA, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington Autism Center, University of Washington, Seattle, WA, USA
| | - Jessica Brian
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Kevin Bath
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Jed Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Leonard Abbeduto
- University of California, Davis, MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Jason Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA
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27
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Shafer RL, Wang Z, Bartolotti J, Mosconi MW. Visual and somatosensory feedback mechanisms of precision manual motor control in autism spectrum disorder. J Neurodev Disord 2021; 13:32. [PMID: 34496766 PMCID: PMC8427856 DOI: 10.1186/s11689-021-09381-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/11/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) show deficits processing sensory feedback to reactively adjust ongoing motor behaviors. Atypical reliance on visual and somatosensory feedback each have been reported during motor behaviors in ASD suggesting that impairments are not specific to one sensory domain but may instead reflect a deficit in multisensory processing, resulting in reliance on unimodal feedback. The present study tested this hypothesis by examining motor behavior across different visual and somatosensory feedback conditions during a visually guided precision grip force test. METHODS Participants with ASD (N = 43) and age-matched typically developing (TD) controls (N = 23), ages 10-20 years, completed a test of precision gripping. They pressed on force transducers with their index finger and thumb while receiving visual feedback on a computer screen in the form of a horizontal bar that moved upwards with increased force. They were instructed to press so that the bar reached the level of a static target bar and then to hold their grip force as steadily as possible. Visual feedback was manipulated by changing the gain of the force bar. Somatosensory feedback was manipulated by applying 80 Hz tendon vibration at the wrist to disrupt the somatosensory percept. Force variability (standard deviation) and irregularity (sample entropy) were examined using multilevel linear models. RESULTS While TD controls showed increased force variability with the tendon vibration on compared to off, individuals with ASD showed similar levels of force variability across tendon vibration conditions. Individuals with ASD showed stronger age-associated reductions in force variability relative to controls across conditions. The ASD group also showed greater age-associated increases in force irregularity relative to controls, especially at higher gain levels and when the tendon vibrator was turned on. CONCLUSIONS Our findings that disrupting somatosensory feedback did not contribute to changes in force variability or regularity among individuals with ASD suggests a reduced ability to integrate somatosensory feedback information to guide ongoing precision manual motor behavior. We also document stronger age-associated gains in force control in ASD relative to TD suggesting delayed development of multisensory feedback control of motor behavior.
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Affiliation(s)
- Robin L Shafer
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Zheng Wang
- Department of Occupational Therapy, University of Florida, Gainesville, FL, USA
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - James Bartolotti
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Matthew W Mosconi
- Life Span Institute, University of Kansas, Lawrence, KS, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA.
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
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28
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Zampella CJ, Wang LAL, Haley M, Hutchinson AG, de Marchena A. Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review. Curr Psychiatry Rep 2021; 23:64. [PMID: 34387753 DOI: 10.1007/s11920-021-01280-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This review synthesizes recent, clinically relevant findings on the scope, significance, and centrality of motor skill differences in autism spectrum disorder (ASD). RECENT FINDINGS Motor challenges in ASD are pervasive, clinically meaningful, and highly underrecognized, with up to 87% of the autistic population affected but only a small percentage receiving motor-focused clinical care. Across development, motor differences are associated with both core autism symptoms and broader functioning, though the precise nature of those associations and the specificity of motor profiles to ASD remain unestablished. Findings suggest that motor difficulties in ASD are quantifiable and treatable, and that detection and intervention efforts targeting motor function may also positively influence social communication. Recent evidence supports a need for explicit recognition of motor impairment within the diagnostic framework of ASD as a clinical specifier. Motor differences in ASD warrant greater clinical attention and routine incorporation into screening, evaluation, and treatment planning.
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Affiliation(s)
- Casey J Zampella
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Leah A L Wang
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Margaret Haley
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anne G Hutchinson
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ashley de Marchena
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, USA
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29
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Unruh KE, McKinney WS, Bojanek EK, Fleming KK, Sweeney JA, Mosconi MW. Initial action output and feedback-guided motor behaviors in autism spectrum disorder. Mol Autism 2021; 12:52. [PMID: 34246292 PMCID: PMC8272343 DOI: 10.1186/s13229-021-00452-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sensorimotor issues are common in autism spectrum disorder (ASD), related to core symptoms, and predictive of worse functional outcomes. Deficits in rapid behaviors supported primarily by feedforward mechanisms, and continuous, feedback-guided motor behaviors each have been reported, but the degrees to which they are distinct or co-segregate within individuals and across development are not well understood. METHODS We characterized behaviors that varied in their involvement of feedforward control relative to feedback control across skeletomotor (precision grip force) and oculomotor (saccades) control systems in 109 individuals with ASD and 101 age-matched typically developing controls (range: 5-29 years) including 58 individuals with ASD and 57 controls who completed both grip and saccade tests. Grip force was examined across multiple force (15, 45, and 85% MVC) and visual gain levels (low, medium, high). Maximum grip force also was examined. During grip force tests, reaction time, initial force output accuracy, variability, and entropy were examined. For the saccade test, latency, accuracy, and trial-wise variability of latency and accuracy were examined. RESULTS Relative to controls, individuals with ASD showed similar accuracy of initial grip force but reduced accuracy of saccadic eye movements specific to older ages of our sample. Force variability was greater in ASD relative to controls, but saccade gain variability (across trials) was not different between groups. Force entropy was reduced in ASD, especially at older ages. We also find reduced grip strength in ASD that was more severe in dominant compared to non-dominant hands. LIMITATIONS Our age-related findings rely on cross-sectional data. Longitudinal studies of sensorimotor behaviors and their associations with ASD symptoms are needed. CONCLUSIONS We identify reduced accuracy of initial motor output in ASD that was specific to the oculomotor system implicating deficient feedforward control that may be mitigated during slower occurring behaviors executed in the periphery. Individuals with ASD showed increased continuous force variability but similar levels of trial-to-trial saccade accuracy variability suggesting that feedback-guided refinement of motor commands is deficient specifically when adjustments occur rapidly during continuous behavior. We also document reduced lateralization of grip strength in ASD implicating atypical hemispheric specialization.
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Affiliation(s)
- Kathryn E Unruh
- Life Span Institute, University of Kansas, Lawrence, KS, USA
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Walker S McKinney
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Erin K Bojanek
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | | | - John A Sweeney
- Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
| | - Matthew W Mosconi
- Life Span Institute, University of Kansas, Lawrence, KS, USA.
- Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA.
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
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30
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Licari MK, Varcin K, Hudry K, Leonard HC, Alvares GA, Pillar SV, Stevenson PG, Cooper MN, Whitehouse AJO. The course and prognostic capability of motor difficulties in infants showing early signs of autism. Autism Res 2021; 14:1759-1768. [PMID: 34021977 DOI: 10.1002/aur.2545] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 11/12/2022]
Abstract
Delays within the motor domain are often overlooked as an early surveillance marker for autism. The present study evaluated motor difficulties and its potential as an early predictive marker for later autism likelihood in a cohort of infants (N = 96) showing early behavioral signs of autism aged 9-14 months. The motor domain was evaluated using the motor subscales of the Mullen Scales of Early Learning at baseline, and at a 6-month follow-up. The Autism Diagnostic Observation Schedule - Toddler Module (ADOS-T) was completed at follow-up as a measure of autism likelihood. Motor difficulties were common at baseline, with 63/96 (65.6%) infants scoring very low or below average in the gross motor domain and 29/96 (30.2%) in the fine motor domain. At follow-up, gross motor difficulties had resolved for many, with 23/63 (36.5%) infants maintaining these difficulties. Fine motor difficulties resolved in fewer infants, with 20/29 (69.0%) continuing to present with fine motor delays at follow-up. Adjusted linear regression models suggested that fine motor scores at baseline (β = -0.12, SE = 0.04) and follow-up (β = -0.17, SE = 0.05) were associated with higher ADOS-T scores; with difficulties across both timepoints (β = 5.60, SE = 1.35) the strongest (largest in magnitude) association with ADOS-T scores of the predictors examined. Motor difficulties are prominent in children displaying emerging signs of autism, with persistent fine motor difficulties predictive of the developing autism phenotype. The findings indicate the potential clinical value of including evaluation of motor skills within early autism surveillance measures. LAY SUMMARY: This prospective study evaluated motor development over a 6-month period in infants showing early behavioral signs of autism. Atypical motor development was a common feature of infants showing early signs of autism and persistent fine motor difficulties were predictive of the emerging autism phenotype.
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Affiliation(s)
- Melissa K Licari
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Kandice Varcin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Kristelle Hudry
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | | | - Gail A Alvares
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Sarah V Pillar
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Paul G Stevenson
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew N Cooper
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew J O Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
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31
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Di Lorenzo R, Munsters NM, Ward EK, de Jonge M, Kemner C, van den Boomen C. Is It Fear? Similar Brain Responses to Fearful and Neutral Faces in Infants with a Heightened Likelihood for Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:961-972. [PMID: 32594334 PMCID: PMC7954762 DOI: 10.1007/s10803-020-04560-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Individuals with autism spectrum disorder (ASD) show atypical processing of facial expressions. Research with autistic toddlers suggests that abnormalities in processing of spatial frequencies (SFs) contribute to such differences. The current event-related-potential (ERP) study investigated differences between 10-month-old infants with high- and low-likelihood for ASD in SF processing and in discrimination of fearful and neutral faces, filtered to contain specific SF. Results indicate no group differences in general processing of higher (HSF, detailed) and lower-SF (LSF, global) information. However, unlike low-likelihood infants, high-likelihood infants do not discriminate between facial expressions when either the LSF or HSF information is available. Combined with previous findings in toddlers, the current results indicate a developmental delay in efficient processing of facial expressions in ASD.
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Affiliation(s)
- Renata Di Lorenzo
- Experimental Psychology, Helmholtz Institute, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands. .,Developmental Psychology, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Nicolette M Munsters
- Experimental Psychology, Helmholtz Institute, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,Developmental Psychology, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Karakter Child and Adolescent Psychiatry, Ede, The Netherlands
| | - Emma K Ward
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Maretha de Jonge
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.,Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands
| | - Chantal Kemner
- Experimental Psychology, Helmholtz Institute, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,Developmental Psychology, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Carlijn van den Boomen
- Experimental Psychology, Helmholtz Institute, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,Developmental Psychology, Utrecht University, Langeveld Building, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
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Canu D, Van der Paelt S, Canal-Bedia R, Posada M, Vanvuchelen M, Roeyers H. Early non-social behavioural indicators of autism spectrum disorder (ASD) in siblings at elevated likelihood for ASD: a systematic review. Eur Child Adolesc Psychiatry 2021; 30:497-538. [PMID: 32088859 PMCID: PMC8041710 DOI: 10.1007/s00787-020-01487-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/31/2020] [Indexed: 12/19/2022]
Abstract
We aimed at identifying early non-social behavioural indicators that predict later ASD. Likewise, we were interested in the moment in which non-social signs discriminate between children at elevated likelihood for ASD with a later diagnosis of ASD, and children at elevated likelihood for ASD with a typical developmental outcome. In addition, we intended to explore the developmental evolution of children's symptomatology over time. A systematic literature search was conducted for longitudinal studies on early non-social behavioural indicators among siblings at elevated likelihood for ASD. The following databases were searched: PUBMED, Web of Science, PsycINFO, CINAHL and EMBASE. The study identification process was conducted by two reviewers independently. Compared to siblings at elevated likelihood for ASD with a typical developmental outcome, siblings at elevated likelihood for ASD with later ASD show impairments in attention disengagement, in gross and fine motor development and characteristic restricted and repetitive interests and behaviours, starting at 12 months of age. Moreover, early attention disengagement exerts a predictive role towards a later ASD diagnosis, given that from 12 months siblings at elevated likelihood for ASD who will receive an independent ASD diagnosis towards 24-36 months present marked difficulties in disengaging in comparison with siblings at elevated likelihood for ASD that will not satisfy the criteria for an ASD diagnosis. The findings call for a more comprehensive vision on early indicators of ASD. Further research is needed to extend results to other behavioural domains.
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Affiliation(s)
- Daniela Canu
- Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL), Hasselt Unversity, Agoralaan, Building A, 3590 Diepenbeek, Hasselt, Belgium.
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Sara Van der Paelt
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ricardo Canal-Bedia
- Instituto Universitario de Integración en la Comunidad (INICO), University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Institute of Rare Diseases Research & CIBERER, Instituto de Salud Carlos III, Madrid, Spain
| | - Marleen Vanvuchelen
- Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL), Hasselt Unversity, Agoralaan, Building A, 3590 Diepenbeek, Hasselt, Belgium
| | - Herbert Roeyers
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Bondioli M, Chessa S, Narzisi A, Pelagatti S, Zoncheddu M. Towards Motor-Based Early Detection of Autism Red Flags: Enabling Technology and Exploratory Study Protocol. SENSORS 2021; 21:s21061971. [PMID: 33799643 PMCID: PMC7998381 DOI: 10.3390/s21061971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/27/2022]
Abstract
Observing how children manipulate objects while they are playing can help detect possible autism spectrum disorders (ASD) at an early stage. For this purpose, specialists seek the so-called “red-flags” of motor signature of ASD for more precise diagnostic tests. However, a significant drawback to achieve this is that the observation of object manipulation by the child very often is not naturalistic, as it involves the physical presence of the specialist and is typically performed in hospitals. In this framework, we present a novel Internet of Things support in the form factory of a smart toy that can be used by specialists to perform indirect and non-invasive observations of the children in naturalistic conditions. While they play with the toy, children can be observed in their own environment and without the physical presence of the specialist. We also present the technical validation of the technology and the study protocol for the refinement of the diagnostic practice based on this technology.
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Affiliation(s)
- Mariasole Bondioli
- Department of Computer Science, University of Pisa, Largo Pontecorvo 3, 56127 Pisa, Italy; (M.B.); (S.C.); (S.P.); (M.Z.)
| | - Stefano Chessa
- Department of Computer Science, University of Pisa, Largo Pontecorvo 3, 56127 Pisa, Italy; (M.B.); (S.C.); (S.P.); (M.Z.)
| | - Antonio Narzisi
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56018 Pisa, Italy
- Correspondence:
| | - Susanna Pelagatti
- Department of Computer Science, University of Pisa, Largo Pontecorvo 3, 56127 Pisa, Italy; (M.B.); (S.C.); (S.P.); (M.Z.)
| | - Michele Zoncheddu
- Department of Computer Science, University of Pisa, Largo Pontecorvo 3, 56127 Pisa, Italy; (M.B.); (S.C.); (S.P.); (M.Z.)
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Tanner A, Dounavi K. The Emergence of Autism Symptoms Prior to 18 Months of Age: A Systematic Literature Review. J Autism Dev Disord 2021; 51:973-993. [PMID: 32734422 DOI: 10.1007/s10803-020-04618-w/tables/3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Pre-diagnostic intervention for autism spectrum disorder (ASD) allows symptoms to be addressed as they emerge, often between six to 18 months, rather than after the full onset of the disorder. A systematic literature review, spanning the previous six years was conducted in order to provide an updated review looking at the earliest behavior symptoms of ASD. All included studies used a prospective experimental design, reported on symptoms that emerged before 18-months of age, exclusively in children who would later receive a diagnosis, and were assessed for quality. This review is the first to address this research question through the use of a systematic research design and extends the literature by following up on recommendations for future research from previous findings.
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Affiliation(s)
- Amy Tanner
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| | - Katerina Dounavi
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
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35
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Tanner A, Dounavi K. The Emergence of Autism Symptoms Prior to 18 Months of Age: A Systematic Literature Review. J Autism Dev Disord 2021; 51:973-993. [PMID: 32734422 PMCID: PMC7954747 DOI: 10.1007/s10803-020-04618-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pre-diagnostic intervention for autism spectrum disorder (ASD) allows symptoms to be addressed as they emerge, often between six to 18 months, rather than after the full onset of the disorder. A systematic literature review, spanning the previous six years was conducted in order to provide an updated review looking at the earliest behavior symptoms of ASD. All included studies used a prospective experimental design, reported on symptoms that emerged before 18-months of age, exclusively in children who would later receive a diagnosis, and were assessed for quality. This review is the first to address this research question through the use of a systematic research design and extends the literature by following up on recommendations for future research from previous findings.
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Affiliation(s)
- Amy Tanner
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| | - Katerina Dounavi
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
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36
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Zwaigenbaum L, Bryson SE, Brian J, Smith IM, Sacrey L, Armstrong V, Roberts W, Szatmari P, Garon N, Vaillancourt T, Roncadin C. Assessment of Autism Symptoms From 6 to 18 Months of Age Using the Autism Observation Scale for Infants in a Prospective High-Risk Cohort. Child Dev 2020; 92:1187-1198. [PMID: 33368222 DOI: 10.1111/cdev.13485] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objectives were to characterize behavioral signs of autism spectrum disorder (ASD) in younger siblings of diagnosed children (high-risk; HR) and examine classification features of the Autism Observation Scale for Infants (AOSI). Participants (501 HR and 180 low-risk [LR]) were assessed between 6 and 18 months using the AOSI and at age 3 for ASD diagnoses. Total AOSI scores differentiated HR infants later diagnosed with ASD starting at 12 months. ROC analyses identified 12- and 18-month cutoff scores associated with 0.52 sensitivity and 0.74 specificity and 0.73 sensitivity and 0.65 specificity, respectively. Although classification accuracy does not support use as a standalone screen, the AOSI identifies features associated with ASD starting at 6 months and differentiates HR infants with ASD by 12 months.
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Affiliation(s)
| | | | | | | | | | | | - Wendy Roberts
- Integrated Services for Autism and Neurodevelopmental Disorders
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Begum Ali J, Charman T, Johnson MH, Jones EJH. Early Motor Differences in Infants at Elevated Likelihood of Autism Spectrum Disorder and/or Attention Deficit Hyperactivity Disorder. J Autism Dev Disord 2020; 50:4367-4384. [PMID: 32328858 PMCID: PMC7677154 DOI: 10.1007/s10803-020-04489-1] [Citation(s) in RCA: 11] [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] [Indexed: 12/27/2022]
Abstract
We investigated infant's manual motor behaviour; specifically behaviours crossing the body midline. Infants at elevated likelihood of Autism Spectrum Disorder (ASD) and/or Attention Deficit Hyperactivity Disorder (ADHD) produced fewer manual behaviours that cross the midline compared to infants with a typical likelihood of developing these disorders; however this effect was limited to 10-month-olds and not apparent at age 5 and 14 months. Although, midline crossing did not predict ASD traits, it was related to ADHD traits at 2 years of age. We rule out motor ability and hand dominance as possible explanations for this pattern of behaviour, positing that these results may be a consequence of multisensory integration abilities, and the neurobehavioural shift period, in the first year of life.
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Affiliation(s)
- Jannath Begum Ali
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, Henry Wellcome Building, Malet Street, London, WC1E 7HX, UK.
| | - Tony Charman
- Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mark H Johnson
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, Henry Wellcome Building, Malet Street, London, WC1E 7HX, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Emily J H Jones
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, Henry Wellcome Building, Malet Street, London, WC1E 7HX, UK
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38
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Abstract
An early diagnosis of autism spectrum disorder, leading to a timely enabling intervention, is associated with a better long-term prognosis and allows the early detection of any medical comorbidities that are sometimes found in individuals with autism. It is, therefore, an important challenge to begin the diagnostic procedure of these children as soon as possible. Nowadays, much progress has been made in this respect compared with the past, but considerable work remains. A fundamental role in starting a correct and timely diagnostic procedure is obviously played by the pediatrician. Today, many tools are available for the early screening of autism in the general population, but unfortunately, their real effectiveness has yet to be established. In this narrative review, we address the topic of the early diagnosis of autism spectrum disorder, emphasizing, in particular, those that are now considered the first warning signs. We list a few of the most important signs to consider when a child aged around 18 months presents to a pediatrician, subdivided into three subgroups: social-communication skills; patterns of behavior, interests, or activities; and sensory behaviors and reactivity/temperament. We deal separately with the possible presence of slight motor signs, which can also go unnoticed, but probably they should be considered as very early signs appearing even before social-communication deficits.
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van den Berg L, Gredebäck G. The sticky mittens paradigm: A critical appraisal of current results and explanations. Dev Sci 2020; 24:e13036. [PMID: 32931065 PMCID: PMC8518992 DOI: 10.1111/desc.13036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 08/06/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022]
Abstract
Almost two decades ago, the sticky mittens paradigm was demonstrated as a way to train reaching and grasping behaviors in pre‐reaching infants, and consequently improve visual attentional abilities. In that first study, Needham and colleagues fitted 3‐month‐old infants with Velcro loop‐covered mittens and allowed them to interact with Velcro hook‐covered toys over the course of 2 weeks. In this review, we scrutinize the 17 studies that have followed those first sticky mittens results in regards to the motor, social perception, and visual attentional domains. Furthermore, we discuss the proposed mechanisms of the sticky mittens training. Current evidence strongly suggests that sticky mittens training facilitates social perception, which is consistent with prior correlational work showing links between action production and action perception. However, studies targeting motor and visual attentional abilities have too diverse results to warrant firm conclusions. We conclude that future research should focus on uncovering if there is a connection between sticky mittens training and motor behavior.
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40
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Jarvis EN, West KL, Iverson JM. Object exploration during the transition to sitting: A study of infants at heightened risk for autism spectrum disorder. INFANCY 2020; 25:640-657. [PMID: 32857443 DOI: 10.1111/infa.12341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 04/05/2020] [Accepted: 04/13/2020] [Indexed: 11/26/2022]
Abstract
Learning to sit promotes infants' object exploration because it offers increased access to objects and an improved position for exploration (e.g., ). Infants at heightened risk (HR) for autism spectrum disorder (ASD) exhibit delays in sitting and differences in object exploration. However, little is known about the association between sitting and object exploration among HR infants. We examined changes in object exploration as HR infants (N = 19) and comparison infants with no family history of ASD (Low Risk; LR; N = 23) gained experience sitting independently. Infants were observed monthly from 2.5 months until 1 month after the onset of independent sitting. At 12, 18, 24, and 36 months, infants completed standardized developmental assessments, and HR infants were assessed for ASD symptoms at 36 months. Although HR infants began sitting later than LR infants, both groups increased time spent grasping, shaking, banging, and mouthing objects as they gained sitting experience. Groups only differed in time spent actively mouthing objects, with LR infants showing a greater increase in active mouthing than HR infants. Findings suggest that HR infants experience a similar progression of object exploration across sitting development, but on a delayed time scale.
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Affiliation(s)
- Erin N Jarvis
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kelsey L West
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jana M Iverson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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41
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Lidstone DE, Miah FZ, Poston B, Beasley JF, Mostofsky SH, Dufek JS. Children with Autism Spectrum Disorder Show Impairments During Dynamic Versus Static Grip-force Tracking. Autism Res 2020; 13:2177-2189. [PMID: 32830457 DOI: 10.1002/aur.2370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/07/2022]
Abstract
Impairments in visuomotor integration (VMI) may contribute to anomalous development of motor, as well as social-communicative, skills in children with autism spectrum disorder (ASD). However, it is relatively unknown whether VMI impairments are specific to children with ASD versus children with other neurodevelopmental disorders. As such, this study addressed the hypothesis that children with ASD, but not those in other clinical control groups, would show greater deficits in high-VMI dynamic grip-force tracking versus low-VMI static presentation. Seventy-nine children, aged 7-17 years, participated: 22 children with ASD, 17 children with fetal alcohol spectrum disorder (FASD), 18 children with Attention-Deficit Hyperactivity Disorder (ADHD), and 22 typically developing (TD) children. Two grip-force tracking conditions were examined: (1) a low-VMI condition (static visual target) and (2) a high-VMI condition (dynamic visual target). Low-frequency force oscillations <0.5 Hz during the visuomotor task were also examined. Two-way ANCOVAs were used to examine group x VMI and group x frequency effects (α = 0.05). Children with ASD showed a difficulty, above that seen in the ADHD/FASD groups, tracking dynamic, but not static, visual stimuli as compared to TD children. Low-frequency force oscillations <0.25 Hz were also significantly greater in the ASD versus the TD group. This study is the first to report VMI deficits during dynamic versus static grip-force tracking and increased proportion of force oscillations <0.25 Hz during visuomotor tracking in the ASD versus TD group. Dynamic VMI impairments may be a core psychophysiologic feature that could contribute to impaired development of motor and social-communicative skills in ASD. LAY SUMMARY: Children with autism spectrum disorder (ASD) show difficulties using dynamic visual stimuli to guide their own movements compared to their typically developing (TD) peers. It is unknown whether children without a diagnosis of ASD, but with other neurological disorders, show similar difficulties processing dynamic visual stimuli. In this study, we showed that children with ASD show a difficulty using dynamic, but not static, visual stimuli to guide movement that may explain atypical development of motor and social skills.
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Affiliation(s)
- Daniel E Lidstone
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, USA
| | - Faria Z Miah
- Univerisity of Nevada, Las Vegas Medicine Ackerman Autism Center, Las Vegas, Nevada, USA
| | - Brach Poston
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, USA
| | - Julie F Beasley
- Univerisity of Nevada, Las Vegas Medicine Ackerman Autism Center, Las Vegas, Nevada, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Janet S Dufek
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, USA
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The impacts of maternal childhood adversity, stress, and mental health on child development at 6 months in Taiwan: A follow-up study. Dev Psychopathol 2020; 33:970-979. [PMID: 32684201 PMCID: PMC8374618 DOI: 10.1017/s0954579420000267] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Exposure to adverse childhood experiences (ACEs) is not only associated with one's adverse health outcomes in adulthood but also increases the risk of child developmental problems in offspring. However, the mechanisms involved in the transmission of the effects of maternal ACEs to the offspring largely remain unexplored. This study sought to identify possible psychosocial pathways of intergenerational effects of maternal ACEs on child development at 6 months. Data from a longitudinal study on maternal childhood adversity and maternal psychosocial risk during pregnancy as well as maternal mental health problems and child development at 6 months postnatal were used. Structural equation modeling with bootstrapping was used to estimate the indirect effects of maternal ACEs on child development at 6 months. The model showed that maternal ACEs indirectly influenced offspring's development via maternal stressful events during pregnancy and pre- and postnatal mental health problems. This finding highlights the possible interventions at the prenatal and postnatal periods. Early identification of women who have ACEs or who are at psychosocial risk during pre- and postnatal periods is critical to provide interventions to buffer those negative effects on offspring's development. Future studies are needed to longitudinally assess the effects of maternal ACEs on child development over time.
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43
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Early Motor Development Predicts Clinical Outcomes of Siblings at High-Risk for Autism: Insight from an Innovative Motion-Tracking Technology. Brain Sci 2020; 10:brainsci10060379. [PMID: 32560198 PMCID: PMC7349903 DOI: 10.3390/brainsci10060379] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 11/17/2022] Open
Abstract
Atypical motor patterns are potential early markers and predictors of later diagnosis of Autism Spectrum Disorder (ASD). This study aimed to investigate the early motor trajectories of infants at high-risk (HR) of ASD through MOVIDEA, a semi-automatic software developed to analyze 2D and 3D videos and provide objective kinematic features of their movements. MOVIDEA was developed within the Italian Network for early detection of Autism Spectrum Disorder (NIDA Network), which is currently coordinating the most extensive surveillance program for infants at risk for neurodevelopmental disorders (NDDs). MOVIDEA was applied to video recordings of 53 low-risk (LR; siblings of typically developing children) and 50 HR infants’ spontaneous movements collected at 10 days and 6, 12, 18, and 24 weeks. Participants were grouped based on their clinical outcome (18 HR received an NDD diagnosis, 32 HR and 53 LR were typically developing). Results revealed that early developmental trajectories of specific motor parameters were different in HR infants later diagnosed with NDDs from those of infants developing typically. Since MOVIDEA was useful in the association of quantitative measures with specific early motor patterns, it should be applied to the early detection of ASD/NDD markers.
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Srinivasan S, Bhat A. Differences in caregiver behaviors of infants at-risk for autism and typically developing infants from 9 to 15 months of age. Infant Behav Dev 2020; 59:101445. [PMID: 32305735 DOI: 10.1016/j.infbeh.2020.101445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 02/09/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
During an object sharing paradigm, we compared infant-caregiver interactions between two groups: i) infants at high-risk (HR) for being diagnosed with Autism Spectrum Disorder (ASD) and ii) low-risk (LR) infants, observed at 9, 12, and 15 months of age. 16 HR infants (14 infants with an older sibling diagnosed with ASD and 2 preterm infants that received a diagnosis of ASD at 2 years) and 16 LR infants (typically developing infants without older siblings diagnosed with ASD) were included in the study. At each visit, infants played with objects in the presence of their caregivers as crawlers or walkers. Previously, we found that HR infants are less likely to share their object play with caregivers at walker ages. The present study found that caregivers of HR infants used greater directive bids including being more proximal to infants and using greater verbal and non-verbal bids to sustain their infant's attention and to ensure their compliance during the task compared to caregivers of LR infants. Our study emphasizes the bidirectional and dynamic nature of infant-caregiver interactions. Our findings have implications for caregiver training programs that teach parents appropriate strategies to promote early social communication skills in at-risk infants.
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Affiliation(s)
- S Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.
| | - A Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, USA; Biomechanics and Movement Sciences Program, University of Delaware, Newark, DE, USA; Psychological and Brain Sciences, University of Delaware, Newark, DE, USA.
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45
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Behavior and interaction imaging at 9 months of age predict autism/intellectual disability in high-risk infants with West syndrome. Transl Psychiatry 2020; 10:54. [PMID: 32066713 PMCID: PMC7026100 DOI: 10.1038/s41398-020-0743-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 02/07/2023] Open
Abstract
Automated behavior analysis are promising tools to overcome current assessment limitations in psychiatry. At 9 months of age, we recorded 32 infants with West syndrome (WS) and 19 typically developing (TD) controls during a standardized mother-infant interaction. We computed infant hand movements (HM), speech turn taking of both partners (vocalization, pause, silences, overlap) and motherese. Then, we assessed whether multimodal social signals and interactional synchrony at 9 months could predict outcomes (autism spectrum disorder (ASD) and intellectual disability (ID)) of infants with WS at 4 years. At follow-up, 10 infants developed ASD/ID (WS+). The best machine learning reached 76.47% accuracy classifying WS vs. TD and 81.25% accuracy classifying WS+ vs. WS-. The 10 best features to distinguish WS+ and WS- included a combination of infant vocalizations and HM features combined with synchrony vocalization features. These data indicate that behavioral and interaction imaging was able to predict ASD/ID in high-risk children with WS.
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46
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Whole-Body Movement during Videogame Play Distinguishes Youth with Autism from Youth with Typical Development. Sci Rep 2019; 9:20094. [PMID: 31882934 PMCID: PMC6934713 DOI: 10.1038/s41598-019-56362-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 12/04/2019] [Indexed: 11/08/2022] Open
Abstract
Individuals with autism spectrum disorder struggle with motor difficulties throughout the life span, and these motor difficulties may affect independent living skills and quality of life. Yet, we know little about how whole-body movement may distinguish individuals with autism spectrum disorder from individuals with typical development. In this study, kinematic and postural sway data were collected during multiple sessions of videogame play in 39 youth with autism spectrum disorder and 23 age-matched youth with typical development (ages 7–17 years). The youth on the autism spectrum exhibited more variability and more entropy in their movements. Machine learning analysis of the youths’ motor patterns distinguished between the autism spectrum and typically developing groups with high aggregate accuracy (up to 89%), with no single region of the body seeming to drive group differences. Moreover, the machine learning results corresponded to individual differences in performance on standardized motor tasks and measures of autism symptom severity. The machine learning algorithm was also sensitive to age, suggesting that motor challenges in autism may be best characterized as a developmental motor delay rather than an autism-distinct motor profile. Overall, these results reveal that whole-body movement is a distinguishing feature in autism spectrum disorder and that movement atypicalities in autism are present across the body.
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47
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Gonzalez SL, Alvarez V, Nelson EL. Do Gross and Fine Motor Skills Differentially Contribute to Language Outcomes? A Systematic Review. Front Psychol 2019; 10:2670. [PMID: 31849775 PMCID: PMC6901663 DOI: 10.3389/fpsyg.2019.02670] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 11/13/2019] [Indexed: 11/29/2022] Open
Abstract
Background: Changes in motor development provide children with new learning opportunities to interact with objects, their environment, and with caregivers. Previous research finds that both gross and fine motor skills are predictive of later language outcomes across early infancy and childhood. However, gross and fine motor skills afford different types of interactions. Thus, gross and fine motor skills may potentially differ in the developmental trajectories through which cascading changes in language may occur. The aim of the present study was to investigate whether there are differences in the predictive capacities of gross and fine motor skills toward language outcomes across infancy and early childhood in typical development. Method: A systematic review of existing literature on motor-language cascades was conducted in across studies measuring gross and/or fine motor and language development in children from 0 to 5 years old. Searches were conducted in PsycINFO, PubMed, and MEDLINE. Keywords used were a combination of "gross motor," "fine motor," "motor performance," "motor development," or "psychomotor development" along with "language," "language development," or "communication skills." Two independent reviewers screened abstracts and full texts based on inclusion and exclusion criteria. Results: A total of 23 articles were retained. Of these, seven studies measured only gross motor skills, four studies measured only fine motor skills, and 12 studies measured both gross and fine motor skills in the same study. Studies used a variety of measures to assess gross motor skills, fine motor skills, and language development (e.g., parent report, in lab observations, standardized assessment), and findings varied based on analyses used. Results demonstrated that both gross and fine motor skills are related to language outcomes, but due to a smaller amount of studies testing fine motor skills, conclusions regarding whether one is more important for language outcomes cannot be drawn. Conclusions: We conclude that both gross and fine motor skills help foster language development from infancy to early childhood. Limitations regarding current knowledge regarding the mechanisms that underlie motor-language cascades are discussed, as well as the need for more studies on fine motor skills.
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Affiliation(s)
- Sandy L. Gonzalez
- Department of Psychology, Florida International University, Miami, FL, United States
- Department of Applied Psychology, New York University, New York, NY, United States
| | - Veronica Alvarez
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Eliza L. Nelson
- Department of Psychology, Florida International University, Miami, FL, United States
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48
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Behavioral predictors of autism recurrence are genetically independent and influence social reciprocity: evidence that polygenic ASD risk is mediated by separable elements of developmental liability. Transl Psychiatry 2019; 9:202. [PMID: 31439834 PMCID: PMC6706410 DOI: 10.1038/s41398-019-0545-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 06/24/2019] [Accepted: 07/17/2019] [Indexed: 01/12/2023] Open
Abstract
The preponderance of causal influence on total population attributable risk for autism is polygenic in nature, but it is not known how such liability engenders the development of the syndrome. In 348 epidemiologically ascertained toddler twins, we explored associations between autistic traits and three robust, highly heritable predictors of familial autism recurrence: variation in attention, motor coordination, and parental autistic trait burden. We observed that these predictors-despite collectively accounting for over one third of variance in clinical recurrence-are genetically independent in early childhood, and jointly account for a comparable share of inherited influence on early reciprocal social behavior in the general population. Thus, combinations of what are otherwise discrete, inherited behavioral liabilities-some not specific to autism-appear to jointly mediate common genetic risk for autism. Linking genetic variants and neural signatures to these independent traits prior to the onset of the development of autism will enhance understanding of mechanisms of causation in familial autistic syndromes. Moreover, ongoing biomarker discovery efforts will benefit from controlling for the effects of these common liabilities, which aggregate in individuals with autism but are also continuously distributed in "controls". Finally, early inherited liabilities that participate in the early ontogeny of autistic syndromes represent parsimonious intervention targets for polygenic forms of the condition, and represent candidate trans-diagnostic endophenotypes of potential relevance to a diversity of neuropsychiatric syndromes.
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49
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Bussu G, Jones EJH, Charman T, Johnson MH, Buitelaar JK. Prediction of Autism at 3 Years from Behavioural and Developmental Measures in High-Risk Infants: A Longitudinal Cross-Domain Classifier Analysis. J Autism Dev Disord 2019; 48:2418-2433. [PMID: 29453709 PMCID: PMC5996007 DOI: 10.1007/s10803-018-3509-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We integrated multiple behavioural and developmental measures from multiple time-points using machine learning to improve early prediction of individual Autism Spectrum Disorder (ASD) outcome. We examined Mullen Scales of Early Learning, Vineland Adaptive Behavior Scales, and early ASD symptoms between 8 and 36 months in high-risk siblings (HR; n = 161) and low-risk controls (LR; n = 71). Longitudinally, LR and HR-Typical showed higher developmental level and functioning, and fewer ASD symptoms than HR-Atypical and HR-ASD. At 8 months, machine learning classified HR-ASD at chance level, and broader atypical development with 69.2% Area Under the Curve (AUC). At 14 months, ASD and broader atypical development were classified with approximately 71% AUC. Thus, prediction of ASD was only possible with moderate accuracy at 14 months.
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Affiliation(s)
- G Bussu
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands.
| | - E J H Jones
- Centre for Brain and Cognitive Development, Birkbeck, University of London, 32 Torrington Square, London, WC1E 7JL, UK
| | - T Charman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - M H Johnson
- Centre for Brain and Cognitive Development, Birkbeck, University of London, 32 Torrington Square, London, WC1E 7JL, UK
| | - J K Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
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50
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Moavero R, Benvenuto A, Emberti Gialloreti L, Siracusano M, Kotulska K, Weschke B, Riney K, Jansen FE, Feucht M, Krsek P, Nabbout R, Jansen AC, Wojdan K, Borkowska J, Sadowski K, Hertzberg C, Hulshof H, Samueli S, Benova B, Aronica E, Kwiatkowski DJ, Lagae L, Jozwiak S, Curatolo P. Early Clinical Predictors of Autism Spectrum Disorder in Infants with Tuberous Sclerosis Complex: Results from the EPISTOP Study. J Clin Med 2019; 8:E788. [PMID: 31163675 PMCID: PMC6617179 DOI: 10.3390/jcm8060788] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/25/2019] [Accepted: 05/30/2019] [Indexed: 01/09/2023] Open
Abstract
Autism spectrum disorder (ASD) is highly prevalent in subjects with Tuberous Sclerosis Complex (TSC), but we are not still able to reliably predict which infants will develop ASD. This study aimed to identify the early clinical markers of ASD and/or developmental delay (DD) in infants with an early diagnosis of TSC. We prospectively evaluated 82 infants with TSC (6-24 months of age), using a detailed neuropsychological assessment (Bayley Scales of Infant Development-BSID, and Autism Diagnostic Observation Schedule-ADOS), in the context of the EPISTOP (Long-term, prospective study evaluating clinical and molecular biomarkers of EPIleptogenesiS in a genetic model of epilepsy-Tuberous SclerOsis ComPlex) project (NCT02098759). Normal cognitive developmental quotient at 12 months excluded subsequent ASD (negative predictive value 100%). The total score of ADOS at 12 months clearly differentiated children with a future diagnosis of ASD from children without (p = 0.012). Atypical socio-communication behaviors (p < 0.001) were more frequently observed than stereotyped/repetitive behaviors in children with ASD at 24 months. The combined use of BSID and ADOS can reliably identify infants with TSC with a higher risk for ASD at age 6-12 months, allowing for clinicians to target the earliest symptoms of abnormal neurodevelopment with tailored intervention strategies.
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Affiliation(s)
- Romina Moavero
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
- Child Neurology Unit, Neuroscience and Neurorehabilitation Department, "Bambino Gesù" Children's Hospital, IRCCS, P.zza S. Onofrio 4, 00165 Rome, Italy.
| | - Arianna Benvenuto
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
| | - Leonardo Emberti Gialloreti
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy.
| | - Martina Siracusano
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy.
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Katarzyna Kotulska
- Department of Neurology and Epileptology, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
| | - Bernhard Weschke
- Department of Child Neurology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Kate Riney
- Neuroscience Unit, Queensland Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101, Australia.
- School of Clinical Medicine, University of Queensland, St Lucia, QLD 4072, Australia.
| | - Floor E Jansen
- Department of Child Neurology, Brain Center, University Medical Center Utrecht, 3584 Utrecht, The Netherlands.
| | - Martha Feucht
- Department of Pediatrics, University Hospital Vienna, 1090 Vienna, Austria.
| | - Pavel Krsek
- Motol University Hospital, Charles University, 150 06 Prague, Czech Republic.
| | - Rima Nabbout
- Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Necker- Enfants Malades Hospital, University Paris Descartes, Imagine Institute, 75015 Paris, France.
| | - Anna C Jansen
- Pediatric Neurology Unit-UZ Brussel, 1050 Brussels, Belgium.
| | - Konrad Wojdan
- Warsaw University of Technology, Institute of Heat Engineering, 00-661 Warsaw, Poland.
- Transition Technologies, ul. Pawia 5, 01-030 Warsaw, Poland.
| | - Julita Borkowska
- Department of Neurology and Epileptology, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
| | - Krzystof Sadowski
- Department of Neurology and Epileptology, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
| | - Christoph Hertzberg
- Diagnose und Behandlungszentrum für Kinder und Jugendliche, Vivantes Klinikum Neuköln, 12351 Berlin, Germany.
| | - Hanna Hulshof
- Department of Child Neurology, Brain Center, University Medical Center Utrecht, 3584 Utrecht, The Netherlands.
| | - Sharon Samueli
- Department of Pediatrics, University Hospital Vienna, 1090 Vienna, Austria.
| | - Barbora Benova
- Motol University Hospital, Charles University, 150 06 Prague, Czech Republic.
| | - Eleonora Aronica
- Amsterdam UMC, University of Amsterdam, Department of (Neuro)Pathology, Amsterdam Neuroscience, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Stichting Epilepsie Instellingen Nederland (SEIN), The Netherlands.
| | - David J Kwiatkowski
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Lieven Lagae
- Department of Development and Regeneration-Section Pediatric Neurology, University Hospitals KU Leuven, 3000 Leuven, Belgium.
| | - Sergiusz Jozwiak
- Department of Neurology and Epileptology, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland.
- Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland Zwirki i Wigury 63A, 02-091 Warsaw, Poland.
| | - Paolo Curatolo
- Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.
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