3
|
Pride NA, Haebich KM, Walsh KS, Lami F, Rouel M, Maier A, Chisholm AK, Lorenzo J, Hearps SJC, North KN, Payne JM. Sensory Processing in Children and Adolescents with Neurofibromatosis Type 1. Cancers (Basel) 2023; 15:3612. [PMID: 37509275 PMCID: PMC10377664 DOI: 10.3390/cancers15143612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Despite the evidence of elevated autistic behaviors and co-occurring neurodevelopmental difficulties in many children with neurofibromatosis type 1 (NF1), we have a limited understanding of the sensory processing challenges that may occur with the condition. This study examined the sensory profile of children and adolescents with NF1 and investigated the relationships between the sensory profiles and patient characteristics and neuropsychological functioning. The parent/caregivers of 152 children with NF1 and 96 typically developing children completed the Sensory Profile 2 (SP2), along with standardized questionnaires assessing autistic behaviors, ADHD symptoms, internalizing symptoms, adaptive functioning, and social skills. Intellectual functioning was also assessed. The SP2 data indicated elevated sensory processing problems in children with NF1 compared to typically developing children. Over 40% of children with NF1 displayed differences in sensory registration (missing sensory input) and were unusually sensitive to and unusually avoidant of sensory stimuli. Sixty percent of children with NF1 displayed difficulties in one or more sensory modalities. Elevated autistic behaviors and ADHD symptoms were associated with more severe sensory processing difficulties. This first detailed assessment of sensory processing, alongside other clinical features, in a relatively large cohort of children and adolescents with NF1 demonstrates the relationships between sensory processing differences and adaptive skills and behavior, as well as psychological well-being. Our characterization of the sensory profile within a genetic syndrome may help facilitate more targeted interventions to support overall functioning.
Collapse
Affiliation(s)
- Natalie A Pride
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia
| | - Kristina M Haebich
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Karin S Walsh
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, George Washington University School of Medicine, Washington, DC 20052, USA
| | - Francesca Lami
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Melissa Rouel
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia
| | - Alice Maier
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Anita K Chisholm
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
- Royal Children's Hospital, Parkville, VIC 3052, Australia
| | - Jennifer Lorenzo
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia
| | | | - Kathryn N North
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - Jonathan M Payne
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
- Royal Children's Hospital, Parkville, VIC 3052, Australia
| |
Collapse
|
4
|
Chisholm AK, Haebich KM, Pride NA, Walsh KS, Lami F, Ure A, Maloof T, Brignell A, Rouel M, Granader Y, Maier A, Barton B, Darke H, Dabscheck G, Anderson VA, Williams K, North KN, Payne JM. Delineating the autistic phenotype in children with neurofibromatosis type 1. Mol Autism 2022; 13:3. [PMID: 34983638 PMCID: PMC8729013 DOI: 10.1186/s13229-021-00481-3] [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] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022] Open
Abstract
Background Existing research has demonstrated elevated autistic behaviours in children with neurofibromatosis type 1 (NF1), but the autistic phenotype and its relationship to other neurodevelopmental manifestations of NF1 remains unclear. To address this gap, we performed detailed characterisation of autistic behaviours in children with NF1 and investigated their association with other common NF1 child characteristics. Methods Participants were drawn from a larger cross-sectional study examining autism in children with NF1. The population analysed in this study scored above threshold on the Social Responsiveness Scale-Second Edition (T-score ≥ 60; 51% larger cohort) and completed the Autism Diagnostic Interview-Revised (ADI-R) and/or the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). All participants underwent evaluation of their intellectual function, and behavioural data were collected via parent questionnaires. Results The study cohort comprised 68 children (3–15 years). Sixty-three per cent met the ADOS-2 ‘autism spectrum’ cut-off, and 34% exceeded the more stringent threshold for ‘autistic disorder’ on the ADI-R. Social communication symptoms were common and wide-ranging, while restricted and repetitive behaviours (RRBs) were most commonly characterised by ‘insistence on sameness’ (IS) behaviours such as circumscribed interests and difficulties with minor changes. Autistic behaviours were weakly correlated with hyperactive/impulsive attention deficit hyperactivity disorder (ADHD) symptoms but not with inattentive ADHD or other behavioural characteristics. Language and verbal IQ were weakly related to social communication behaviours but not to RRBs. Limitations Lack of genetic validation of NF1, no clinical diagnosis of autism, and a retrospective assessment of autistic behaviours in early childhood. Conclusions Findings provide strong support for elevated autistic behaviours in children with NF1. While these behaviours were relatively independent of other NF1 comorbidities, the importance of taking broader child characteristics into consideration when interpreting data from autism-specific measures in this population is highlighted. Social communication deficits appear similar to those observed in idiopathic autism and are coupled with a unique RRB profile comprising prominent IS behaviours. This autistic phenotype and its relationship to common NF1 comorbidities such as anxiety and executive dysfunction will be important to examine in future research. Current findings have important implications for the early identification of autism in NF1 and clinical management. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00481-3.
Collapse
Affiliation(s)
- Anita K Chisholm
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Kristina M Haebich
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Natalie A Pride
- Kids Neuroscience Centre, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Karin S Walsh
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Michigan Avenue NW, Washington, DC, 20310, USA
| | - Francesca Lami
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Alex Ure
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.,Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Tiba Maloof
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Amanda Brignell
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Melissa Rouel
- Kids Neuroscience Centre, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Yael Granader
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Michigan Avenue NW, Washington, DC, 20310, USA
| | - Alice Maier
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Belinda Barton
- Kids Neuroscience Centre, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, 2050, Australia.,Children's Hospital Education Research Institute, The Children's Hospital at Westmead, 178A Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Hayley Darke
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Gabriel Dabscheck
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Vicki A Anderson
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Katrina Williams
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.,Department of Paediatrics, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.,Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Kathryn N North
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Jonathan M Payne
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia. .,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia. .,The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia.
| |
Collapse
|
5
|
Fombonne E, Morotti H, Mastel S, Keller K, Barnard RA, Hall T, O'Roak BJ. Autism questionnaire scores do not only rise because of autism. Dev Med Child Neurol 2021; 63:235-236. [PMID: 33118173 DOI: 10.1111/dmcn.14725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Eric Fombonne
- Department of Psychiatry, Oregon Health & Science University (OHSU), Portland, OR, USA.,Department of Pediatrics & Institute on Development & Disability, OHSU, Portland, OR, USA
| | - Hadley Morotti
- Department of Molecular and Medical Genetics, OHSU, Portland, OR, USA
| | - Sarah Mastel
- Department of Psychiatry, Oregon Health & Science University (OHSU), Portland, OR, USA.,Department of Pediatrics & Institute on Development & Disability, OHSU, Portland, OR, USA
| | - Kory Keller
- Department of Molecular and Medical Genetics, OHSU, Portland, OR, USA
| | - Rebecca A Barnard
- Department of Molecular and Medical Genetics, OHSU, Portland, OR, USA
| | - Trevor Hall
- Department of Pediatrics & Institute on Development & Disability, OHSU, Portland, OR, USA
| | - Brian J O'Roak
- Department of Molecular and Medical Genetics, OHSU, Portland, OR, USA
| |
Collapse
|