1
|
Molani-Gol R, Alizadeh M, Kheirouri S, Hamedi-Kalajahi F. The early life growth of head circumference, weight, and height in infants with autism spectrum disorders: a systematic review. BMC Pediatr 2023; 23:619. [PMID: 38066466 PMCID: PMC10704616 DOI: 10.1186/s12887-023-04445-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUNDS The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association between the early life growth of head circumference (HC), weight, and height with ASD in infants. METHODS PubMed, Scopus, Science Direct, and Google Scholar databases were searched up to November 2021 using relevant keywords. All original articles are written in English evaluating the early life growth of HC, weight, and height in infants with ASD were eligible for the present review. RESULTS Totally, 23 articles involving 4959 infants were included in this review. Of 13 studies that evaluated HC of infants at birth, 10 studies (83.33%) showed that the HC at the birth of autistic children was similar to that of the average found in the control group. Among 21 studies that evaluated the HC and weight status in infants, 19 studies (90.47%) showed that autistic children had larger HC and weight than the control group or abnormal acceleration of head growth during infancy. Height growth of infants was investigated in 13 studies, of which 10 cases (76.92%) reported that infants with ASD were significantly longer than control groups. Most of he included studies had a good quality. CONCLUSIONS The findings suggest that in infants with ASD, without the contribution of birth growth factors and sex of the child, the growth of HC, weight, and height probably was faster than in infants with normal development, in early life. Therefore, these measurements might be useful as initial predictive biomarkers for the risk of developing ASD.
Collapse
Affiliation(s)
- Roghayeh Molani-Gol
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St, 14711, Tabriz, 5166614711, Iran
| | - Mohammad Alizadeh
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St, 14711, Tabriz, 5166614711, Iran
| | - Sorayya Kheirouri
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St, 14711, Tabriz, 5166614711, Iran.
| | - Fatemeh Hamedi-Kalajahi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St, 14711, Tabriz, 5166614711, Iran
| |
Collapse
|
2
|
Han L, Guan L, Zhang Z, Li W, Li J, Bao C, Ye M, Tang M, Ke X. Risk factors and clinical characteristics of autism spectrum disorder with regression in China. Autism Res 2023; 16:1836-1846. [PMID: 37578311 DOI: 10.1002/aur.3008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023]
Abstract
Autism spectrum disorder with regression (ASD-R) is characterized by the loss of previously acquired skills during the initial year of life. This study aimed to investigate the clinical characteristics, patterns of regression, and potential risk factors associated with ASD-R in the Chinese Han population. A case-control study was conducted between September 2020 and March 2022. A total of 186 children were enrolled, including 58 children with ASD-R, 70 with ASD without regression (ASD-NR), and 58 typically developing children. Demographic information, clinical characteristics, and potential risk factors related to ASD-R were assessed using a combination of questionnaires, interviews, and physician assessments. The results revealed that children with ASD-R exhibited more severe impairments in social communication and stereotyped behaviors compared with those with ASD-NR. Language regression, constituting 40% of cases within the ASD-R group, was found to be the most common type of regression. Furthermore, our analysis revealed that fever (OR = 4.01, 95% CI: 1.26-12.76) and diarrhea (OR = 6.32, 95% CI: 1.38-29.03) were identified as significant risk factors for ASD-R. These findings contribute to our understanding of the heterogeneity of ASD and highlight the importance of considering immune responses and gastrointestinal factors in the etiology of ASD-R.
Collapse
Affiliation(s)
- Lu Han
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Luyang Guan
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ziyi Zhang
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenqing Li
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jinhui Li
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chenxi Bao
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Mei Ye
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing Jiangning District Maternal and Child Health Care Institute, Nanjing, China
| | - Min Tang
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing Jiangning District Maternal and Child Health Care Institute, Nanjing, China
| | - Xiaoyan Ke
- Child Mental Health Research Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| |
Collapse
|
3
|
Rahaman MA, Lopa M, Uddin KMF, Baqui MA, Keya SP, Faruk MO, Sarker S, Basiruzzaman M, Islam M, AlBanna A, Jahan N, Chowdhury MAKA, Saha N, Hussain M, Colombi C, O'Rielly D, Woodbury-Smith M, Ghaziuddin M, Rahman MM, Uddin M. An Exploration of Physical and Phenotypic Characteristics of Bangladeshi Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:2392-2401. [PMID: 32975665 DOI: 10.1007/s10803-020-04703-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study explored the physical and clinical phenotype of Bangladeshi children with autism spectrum disorder (ASD). A totally of 283 children who were referred for screening and administered Module 1 of the Autism Diagnostic Observation Schedule (ADOS) were included. Overall, 209 met the ADOS algorithmic cutoff for ASD. A trend for greater weight and head circumference was observed in children with ASD versus non-ASD. Head circumference was significantly (p < 0.03) larger in ASD males compared with non-ASD males. A trend was also observed for symptom severity, higher in females than males (p = 0.068), with further analyses demonstrating that social reciprocity (p < 0.014) and functional play (p < 0.03) were significantly more impaired in ASD females than males. The findings help understand sex differences in ASD.
Collapse
Affiliation(s)
- Md Ashiquir Rahaman
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Maksuda Lopa
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - K M Furkan Uddin
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Holy Family Red Crescent Medical College, Dhaka, Bangladesh
| | - Md Abdul Baqui
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Selina Parvin Keya
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Md Omar Faruk
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Shaoli Sarker
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Department of Paediatric Neuroscience, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Mohammed Basiruzzaman
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Mazharul Islam
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh.,Genetics and Genomic Medicine Centre, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - Ammar AlBanna
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.,Al Jalila Specialty Children's Hospital, Dubai, UAE
| | - Nargis Jahan
- Centre for Precision Therapeutics, NeuroGen Children's Healthcare, Dhaka, Bangladesh
| | - M A K Azad Chowdhury
- Neonatology, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Narayan Saha
- Department of Paediatric Neurology, National Institute of Neurosciences, Dhaka, Bangladesh
| | - Manzoor Hussain
- Department of Paediatric Cardiology, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Costanza Colombi
- Department of Paediatric Cardiology, Dhaka Shishu Hospital, Dhaka, Bangladesh
| | - Darren O'Rielly
- Faculty of Medicine, Centre for Translational Genomics, Memorial University, St. Johns, Canada
| | - Marc Woodbury-Smith
- Department of Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada.,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | | | - Mohammad Mizanur Rahman
- Department of Paediatric Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mohammed Uddin
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE. .,Department of Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada.
| |
Collapse
|
4
|
Manelis L, Meiri G, Ilan M, Flusser H, Michaelovski A, Faroy M, Kerub O, Dinstein I, Menashe I. Language regression is associated with faster early motor development in children with autism spectrum disorder. Autism Res 2019; 13:145-156. [DOI: 10.1002/aur.2197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/19/2019] [Accepted: 07/26/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Liora Manelis
- Psychology DepartmentBen Gurion University Beer Sheva Israel
- Zlotowski Center for NeuroscienceBen Gurion University Beer Sheva Israel
| | - Gal Meiri
- Pre‐School Psychiatry UnitSoroka University Medical Center Beer Sheva Israel
| | - Michal Ilan
- Psychology DepartmentBen Gurion University Beer Sheva Israel
- Pre‐School Psychiatry UnitSoroka University Medical Center Beer Sheva Israel
| | - Hagit Flusser
- Zusman Child Development CenterSoroka University Medical Center Beer Sheva Israel
| | - Analya Michaelovski
- Zusman Child Development CenterSoroka University Medical Center Beer Sheva Israel
| | - Michal Faroy
- Pre‐School Psychiatry UnitSoroka University Medical Center Beer Sheva Israel
| | | | - Ilan Dinstein
- Psychology DepartmentBen Gurion University Beer Sheva Israel
- Zlotowski Center for NeuroscienceBen Gurion University Beer Sheva Israel
- Cognitive and Brain Sciences DepartmentBen Gurion University Beer Sheva Israel
| | - Idan Menashe
- Zlotowski Center for NeuroscienceBen Gurion University Beer Sheva Israel
- Public Health DepartmentBen Gurion University Beer Sheva Israel
| |
Collapse
|
5
|
Pearson N, Charman T, Happé F, Bolton PF, McEwen FS. Regression in autism spectrum disorder: Reconciling findings from retrospective and prospective research. Autism Res 2018; 11:1602-1620. [PMID: 30475449 DOI: 10.1002/aur.2035] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/21/2018] [Accepted: 09/18/2018] [Indexed: 12/16/2022]
Abstract
The way in which the behavioral manifestations of autism spectrum disorder (ASD) emerge in infancy is variable. Regression-loss of previously acquired skills-occurs in a subset of children. However, the etiology and significance of regression remains unclear. Until recently, investigation of regression relied on retrospective report by parents or examination of home videos from early in life. However, home videos and retrospective report of the nature and timing of regression, and association with factors such as illness or immunization, is potentially subject to bias. The advent of prospective studies of infant siblings at familial high-risk of ASD has the potential to document regression as it occurs. Recent research has suggested that subtle loss of skills occurs in a larger proportion of children with ASD than previously assumed; however, there are few reports of clear-cut regressions, such as that involving dramatic loss of language and other established skills, in the prospective literature. This could be because of the following: clear-cut regression occurs less commonly than parent report suggests, study design limits the potential to detect regression, or there are differences between multiplex and simplex families in the rate of de novo genetic mutations and therefore regression risk. This review will bring together literature from retrospective and prospective research and attempt to reconcile diverging findings, with a specific focus on methodological issues. Changing conceptualizations of regression will be discussed, as well as etiological factors that may be associated with regression. The main challenges that need to be addressed to measure regression in prospective studies will be set out. Autism Research 2018, 11: 1602-1620. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Regression-a loss of previously established skills-occurs in a subset of children with ASD. Parental recall is not always accurate but studying younger siblings of children with ASD, 10-20% of whom will develop ASD, should make it possible to measure regression as it occurs. Clear-cut regression, like loss of language, has not often been reported in infant sibling studies, but recent research suggests that gradual loss of social engagement might be more common. This review looks at the evidence for regression from infant sibling studies and asks how study design affects the likelihood of capturing regression.
Collapse
Affiliation(s)
- Niamh Pearson
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley National Health Service (NHS) Foundation Trust, Maudsley Hospital, London, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Patrick F Bolton
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley National Health Service (NHS) Foundation Trust, Maudsley Hospital, London, UK.,Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Fiona S McEwen
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Biological & Experimental Psychology, School of Biological & Chemical Sciences, Queen Mary University of London, London, UK
| |
Collapse
|
6
|
Green CC, Dissanayake C, Loesch DZ, Bui M, Barbaro J. Skeletal Growth Dysregulation in Australian Male Infants and Toddlers With Autism Spectrum Disorder. Autism Res 2018; 11:846-856. [PMID: 29624910 DOI: 10.1002/aur.1952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 02/20/2018] [Accepted: 03/05/2018] [Indexed: 11/06/2022]
Abstract
Recent findings suggest that children with Autism Spectrum Disorder (ASD) are larger in size for head circumference (HC), height, and weight compared to typically developing (TD) children; however, little is known about their rate of growth, especially in height and weight. The current study aimed to: (a) confirm and extend upon previous findings of early generalized overgrowth in ASD; and (b) determine if there were any differences in the rate of growth between infants and toddlers with ASD compared to their TD peers. Measurements of HC, height, and weight were available for 135 boys with ASD and 74 TD boys, from birth through 3 years of age. Size and growth rate in HC, height, and weight were analyzed using a linear mixed-effects model. Infants with ASD were significantly smaller in size at birth for HC, body length, and weight compared to TD infants (all P < 0.05); however, they grew at a significantly faster rate in HC and height in comparison to the TD children (P < 0.001); there was no significant difference between the groups in growth rate for weight (P > 0.05). The results confirmed that male infants and toddlers with ASD exhibit skeletal growth dysregulation early in life. Autism Res 2018, 11: 846-856. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Recent findings suggest that infants with Autism Spectrum Disorder (ASD) are smaller in size at birth compared to typically developing infants but grow larger than their peers during the first year. Little is known about their rate of growth, especially for height and weight. Our findings confirmed that infants with ASD are smaller in size at birth for head circumference (HC), height, and weight, but grow at a faster rate in HC and height than their peers from birth to 3 years.
Collapse
Affiliation(s)
- Cherie C Green
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Danuta Z Loesch
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Minh Bui
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| |
Collapse
|
7
|
Abstract
PURPOSE OF REVIEW Studies investigating postnatal brain growth disorders inform the biology underlying the development of human brain circuitry. This research is becoming increasingly important for the diagnosis and treatment of childhood neurodevelopmental disorders, including autism and related disorders. Here, we review recent research on typical and abnormal postnatal brain growth and examine potential biological mechanisms. RECENT FINDINGS Clinically, brain growth disorders are heralded by diverging head size for a given age and sex, but are more precisely characterized by brain imaging, post-mortem analysis, and animal model studies. Recent neuroimaging and molecular biological studies on postnatal brain growth disorders have broadened our view of both typical and pathological postnatal neurodevelopment. Correlating gene and protein function with brain growth trajectories uncovers postnatal biological mechanisms, including neuronal arborization, synaptogenesis and pruning, and gliogenesis and myelination. Recent investigations of childhood neurodevelopmental and neurodegenerative disorders highlight the underlying genetic programming and experience-dependent remodeling of neural circuitry. SUMMARY To understand typical and abnormal postnatal brain development, clinicians and researchers should characterize brain growth trajectories in the context of neurogenetic syndromes. Understanding mechanisms and trajectories of postnatal brain growth will aid in differentiating, diagnosing, and potentially treating neurodevelopmental disorders.
Collapse
|
8
|
Ozonoff S, Li D, Deprey L, Hanzel EP, Iosif AM. Reliability of parent recall of symptom onset and timing in autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:891-896. [PMID: 28903580 DOI: 10.1177/1362361317710798] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Past events are often reported as occurring more recently than they actually took place, an error called forward telescoping. This study examined whether forward telescoping was evident in parent reports of autism spectrum disorder symptom emergence and onset classification. Parents were interviewed when their child was 2-3 years old (Time 1) and approximately 6 years old (Time 2). Significant forward telescoping was found in both age of social regression and age when language milestones were achieved, but not age of language regression. The correspondence between Time 1 and Time 2 onset report was low ( kappa = 0.38). Approximately one-quarter of the sample changed onset categories, most often due to parents not recalling a regression at Time 2 that they had reported at Time 1. These results challenge the use of retrospective methods in determining onset patterns.
Collapse
|
9
|
Dinstein I, Haar S, Atsmon S, Schtaerman H. No evidence of early head circumference enlargements in children later diagnosed with autism in Israel. Mol Autism 2017; 8:15. [PMID: 28344758 PMCID: PMC5363048 DOI: 10.1186/s13229-017-0129-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/09/2017] [Indexed: 11/16/2022] Open
Abstract
Background Large controversy exists regarding the potential existence and clinical significance of larger brain volumes in toddlers who later develop autism. Assessing this relationship is important for determining the clinical utility of early head circumference (HC) measures and for assessing the validity of the early overgrowth hypothesis of autism, which suggests that early accelerated brain development may be a hallmark of the disorder. Methods We performed a retrospective comparison of HC, height, and weight measurements between 66 toddlers who were later diagnosed with autism and 66 matched controls. These toddlers represent an unbiased regional sample from a single health service provider in the southern district of Israel. On average, participating toddlers had >8 measurements between birth and the age of two, which enabled us to characterize individual HC, height, and weight development with high precision and fit a negative exponential growth model to the data of each toddler with exceptional accuracy. Results The analyses revealed that HC sizes and growth rates were not significantly larger in toddlers with autism even when stratifying the autism group based on verbal capabilities at the time of diagnosis. In addition, there were no significant correlations between ADOS scores at the time of diagnosis and HC at any time-point during the first 2 years of life. Conclusions These negative results add to accumulating evidence, which suggest that brain volume is not necessarily larger in toddlers who develop autism. We believe that conflicting results reported in other studies are due to small sample sizes, use of misleading population norms, changes in the clinical definition of autism over time, and/or inclusion of individuals with syndromic autism. While abnormally large brains may be evident in some individuals with autism and more clearly visible in MRI scans, converging evidence from this and other studies suggests that enlarged HC is not a common etiology of the entire autism population. Early HC measures, therefore, offer very limited clinical utility for assessment of autism risk in the general population. Electronic supplementary material The online version of this article (doi:10.1186/s13229-017-0129-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ilan Dinstein
- Psychology Department, Ben Gurion University, Beer Sheva, 84105 Israel.,Cognitive and Brain Sciences Department, Ben Gurion University, Beer Sheva, 84105 Israel
| | - Shlomi Haar
- Cognitive and Brain Sciences Department, Ben Gurion University, Beer Sheva, 84105 Israel
| | - Shir Atsmon
- Cognitive and Brain Sciences Department, Ben Gurion University, Beer Sheva, 84105 Israel
| | - Hen Schtaerman
- Child Development Center, Maccabi Health Services, Beer Sheva, 84893 Israel
| |
Collapse
|
10
|
Zachor DA, Ben-Itzchak E. Specific Medical Conditions Are Associated with Unique Behavioral Profiles in Autism Spectrum Disorders. Front Neurosci 2016; 10:410. [PMID: 27713683 PMCID: PMC5032712 DOI: 10.3389/fnins.2016.00410] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/25/2016] [Indexed: 11/20/2022] Open
Abstract
Autism spectrum disorder (ASD) is a heterogeneous group of disorders which occurs with numerous medical conditions. In previous research, subtyping in ASD has been based mostly on cognitive ability and ASD symptom severity. The aim of the current study was to investigate whether specific medical conditions in ASD are associated with unique behavioral profiles. The medical conditions included in the study were macrocephaly, microcephaly, developmental regression, food selectivity, and sleep problems. The behavioral profile was composed of cognitive ability, adaptive skills, and autism severity, and was examined in each of the aforementioned medical conditions. The study population included 1224 participants, 1043 males and 181 females (M:F ratio = 5.8:1) with a mean age of 49.9 m (SD = 29.4) diagnosed with ASD using standardized tests. Groups with and without the specific medical conditions were compared on the behavioral measures. Developmental regression was present in 19% of the population and showed a more severe clinical presentation, with lower cognitive abilities, more severe ASD symptoms, and more impaired adaptive functioning. Microcephaly was observed in 6.3% of the population and was characterized by a lower cognitive ability and more impaired adaptive functioning in comparison to the normative head circumference (HC) group. Severe food selectivity was found in 9.8% and severe sleep problems in 5.1% of the ASD population. The food selectivity and sleep problem subgroups, both showed more severe autism symptoms only as described by the parents, but not per the professional assessment, and more impaired adaptive skills. Macrocephaly was observed in 7.9% of the ASD population and did not differ from the normative HC group in any of the examined behavioral measures. Based on these findings, two unique medical-behavioral subtypes in ASD that affect inherited traits of cognition and/or autism severity were suggested. The microcephaly phenotype occurred with more impaired cognition and the developmental regression phenotype with widespread, more severe impairments in cognition and autism severity. In contrast, severe food selectivity and sleep problems represent only comorbidities to ASD that affect functioning. Defining specific subgroups in ASD with a unique biological signature and specific behavioral phenotypes may help future genetic and neuroscience research.
Collapse
Affiliation(s)
- Ditza A. Zachor
- Sackler Faculty of Medicine, Tel Aviv UniversityTel Aviv, Israel
- Department of Pediatrics, The Autism Center, Assaf Harofeh Medical CenterZerifin, Israel
| | - Esther Ben-Itzchak
- Department of Pediatrics, The Autism Center, Assaf Harofeh Medical CenterZerifin, Israel
- Department of Communication Disorders, Ariel UniversityAriel, Israel
| |
Collapse
|
11
|
Pierce K, Courchesne E, Bacon E. To Screen or Not to Screen Universally for Autism is not the Question: Why the Task Force Got It Wrong. J Pediatr 2016; 176:182-94. [PMID: 27421956 PMCID: PMC5679123 DOI: 10.1016/j.jpeds.2016.06.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 04/27/2016] [Accepted: 06/02/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Karen Pierce
- Department of Neurosciences and Autism Center of Excellence, School of Medicine, University of California San Diego, La Jolla, CA.
| | - Eric Courchesne
- Department of Neurosciences and Autism Center of Excellence, School of Medicine, University of California San Diego, La Jolla, CA
| | - Elizabeth Bacon
- Department of Neurosciences and Autism Center of Excellence, School of Medicine, University of California San Diego, La Jolla, CA
| |
Collapse
|
12
|
Valvo G, Baldini S, Retico A, Rossi G, Tancredi R, Ferrari AR, Calderoni S, Apicella F, Muratori F, Santorelli FM, Sicca F. Temporal lobe connects regression and macrocephaly to autism spectrum disorders. Eur Child Adolesc Psychiatry 2016; 25. [PMID: 26224585 PMCID: PMC4820486 DOI: 10.1007/s00787-015-0746-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Interictal electroencephalogram (EEG) abnormalities are frequently associated with autism spectrum disorders (ASD), although their relationship with the clinical features of ASD, particularly the regressive onset, remains controversial. The aim of this study was to investigate whether the characteristics of interictal EEG abnormalities might help to distinguish and predict definite phenotypes within the heterogeneity of ASD. We reviewed the awake and sleep interictal EEGs of 220 individuals with idiopathic ASD, either with or without a history of seizures. EEG findings were analyzed with respect to a set of clinical variables to explore significant associations. A brain morphometry study was also carried out on a subgroup of patients. EEG abnormalities were seen in 154/220 individuals (70%) and were mostly focal (p < 0.01) with an anterior localization (p < 0.001). They were detected more frequently during sleep (p < 0.01), and were associated with a regressive onset of ASD (p < 0.05), particularly in individuals with focal temporal localization (p < 0.05). This association was also stronger in regressive patients with concurrent macrocephaly, together with a relative volumetric reduction of the right temporal cortex (p < 0.05). Indeed, concurrence of temporal EEG abnormalities, regression and macrocephaly might possibly define a distinct endophenotype of ASD. EEG-based endophenotypes could be useful to untangle the complexity of ASD, helping to establish anatomic or pathophysiologic subtypes of the disorder.
Collapse
Affiliation(s)
- Giulia Valvo
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | - Sara Baldini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | | | - Giuseppe Rossi
- Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy
| | - Raffaella Tancredi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | - Anna Rita Ferrari
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | - Fabio Apicella
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | - Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | - Filippo Maria Santorelli
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy
| | - Federico Sicca
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Via dei Giacinti 2 - Calambrone, 56128, Pisa, Italy.
| |
Collapse
|
13
|
Sacco R, Gabriele S, Persico AM. Head circumference and brain size in autism spectrum disorder: A systematic review and meta-analysis. Psychiatry Res 2015; 234:239-51. [PMID: 26456415 DOI: 10.1016/j.pscychresns.2015.08.016] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 08/25/2015] [Indexed: 11/29/2022]
Abstract
Macrocephaly and brain overgrowth have been associated with autism spectrum disorder. We performed a systematic review and meta-analysis to provide an overall estimate of effect size and statistical significance for both head circumference and total brain volume in autism. Our literature search strategy identified 261 and 391 records, respectively; 27 studies defining percentages of macrocephalic patients and 44 structural brain imaging studies providing total brain volumes for patients and controls were included in our meta-analyses. Head circumference was significantly larger in autistic compared to control individuals, with 822/5225 (15.7%) autistic individuals displaying macrocephaly. Structural brain imaging studies measuring brain volume estimated effect size. The effect size is higher in low functioning autistics compared to high functioning and ASD individuals. Brain overgrowth was recorded in 142/1558 (9.1%) autistic patients. Finally, we found a significant interaction between age and total brain volume, resulting in larger head circumference and brain size during early childhood. Our results provide conclusive effect sizes and prevalence rates for macrocephaly and brain overgrowth in autism, confirm the variation of abnormal brain growth with age, and support the inclusion of this endophenotype in multi-biomarker diagnostic panels for clinical use.
Collapse
Affiliation(s)
- Roberto Sacco
- Unit of Child and Adolescent NeuroPsychiatry, Laboratory of Molecular Psychiatry and Neurogenetics, University "Campus Bio-Medico", Rome, Italy.
| | - Stefano Gabriele
- Unit of Child and Adolescent NeuroPsychiatry, Laboratory of Molecular Psychiatry and Neurogenetics, University "Campus Bio-Medico", Rome, Italy
| | - Antonio M Persico
- Unit of Child and Adolescent NeuroPsychiatry, Laboratory of Molecular Psychiatry and Neurogenetics, University "Campus Bio-Medico", Rome, Italy; Mafalda Luce Center for Pervasive Developmental Disorders, Milan, Italy
| |
Collapse
|
14
|
Ranjan S, Nasser JA. Nutritional status of individuals with autism spectrum disorders: do we know enough? Adv Nutr 2015; 6:397-407. [PMID: 26178024 PMCID: PMC4496734 DOI: 10.3945/an.114.007914] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The incidence of individuals with autism spectrum disorders (ASDs) is on the rise; therefore, well-timed screening is important. Given that this is a nutritionally vulnerable population, it is imperative to conduct a detailed nutritional assessment so that timely and intensive interventions can be recommended. This review article summarizes the research, focusing on the nutritional status of individuals with ASDs based on their anthropometric measurements, biomarkers, and dietary assessments. Research examining anthropometric measurements reveals an abnormally accelerated rate of growth among children with autism but shows inconsistent findings on the prevalence of overweight/obesity in comparison with typically growing children. Although dysregulated amino acid metabolism, increased homocysteine, and decreased folate, vitamins B-6 and B-12, and vitamin D concentrations have been proposed as possible biomarkers for an early diagnosis of ASDs, research investigating their association with age, gender, severity, and other comorbid psychiatric/nonpsychiatric disorders is lacking. There is consensus that children with autism have selective eating patterns, food neophobia, limited food repertoire, and sensory issues. Although inadequate micronutrient but adequate macronutrient intakes are increasingly reported, there are inconsistent results about the extent and type of nutrient deficiencies. Identification and development of nutritional assessment indicators that serve as early warning signs during routine practice beginning at birth and extending throughout the child's growth are necessary. With this population aging, there is also a dire need to study the adult population. A more vigorous role by nutrition professionals is warranted because management of potential comorbidities and contributory factors may be particularly problematic.
Collapse
Affiliation(s)
- Sobhana Ranjan
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA
| | | |
Collapse
|
15
|
A review of physical growth in children and adolescents with Autism Spectrum Disorder. DEVELOPMENTAL REVIEW 2015. [DOI: 10.1016/j.dr.2015.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
16
|
Hutsler JJ, Casanova MF. Review: Cortical construction in autism spectrum disorder: columns, connectivity and the subplate. Neuropathol Appl Neurobiol 2015; 42:115-34. [PMID: 25630827 DOI: 10.1111/nan.12227] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 01/16/2015] [Indexed: 01/28/2023]
Abstract
The cerebral cortex undergoes protracted maturation during human development and exemplifies how biology and environment are inextricably intertwined in the construction of complex neural circuits. Autism spectrum disorders are characterized by a number of pathological changes arising from this developmental process. These include: (i) alterations to columnar structure that have significant implications for the organization of cortical circuits and connectivity; (ii) alterations to synaptic spines on individual cortical units that may underlie specific types of connectional changes; and (iii) alterations within the cortical subplate, a region that plays a role in proper cortical development and in regulating interregional communication in the mature brain. Although the cerebral cortex is not the only structure affected in the disorder, it is a fundamental contributor to the behaviours that characterize autism. These alterations to cortical circuitry likely underlie the behavioural phenotype in autism and contribute to the unique pattern of deficits and strengths that characterize cognitive functioning. Recent findings within the cortical subplate may indicate that alterations to cortical construction begin prenatally, before activity-dependent connections are established, and are in need of further study. A better understanding of cortical development in autism spectrum disorders will draw bridges between the microanatomical computational circuitry and the atypical behaviours that arise when that circuitry is modified. In addition, it will allow us to better exploit the constructional plasticity within the brain to design more targeted interventions that better manage atypical cortical construction and that can be applied very early in postnatal life.
Collapse
Affiliation(s)
- Jeffrey J Hutsler
- Department of Psychology, Program in Neuroscience, University of Nevada, Reno, USA
| | - Manuel F Casanova
- Department of Psychiatry and Behavioral Science, University of Louisville School of Medicine, Louisville, USA
| |
Collapse
|
17
|
McKeague IW, Brown AS, Bao Y, Hinkka-Yli-Salomäki S, Huttunen J, Sourander A. Autism with intellectual disability related to dynamics of head circumference growth during early infancy. Biol Psychiatry 2015; 77:833-40. [PMID: 25444163 DOI: 10.1016/j.biopsych.2014.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 06/24/2014] [Accepted: 08/12/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is not yet definitively known whether dynamic features of head circumference growth are associated with autism. To address this issue, we carried out a nested matched case-control study using data from national well baby clinics in Finland; autism cases were identified from the Finnish Hospital and Outpatient Discharge Registry. METHODS A nonparametric Bayesian method was used to construct growth velocity trajectories between birth and 2 years of age in autism cases and matched control subjects (n = 468 in main analyses, 1:1 matched control subjects). Estimates of odds ratios for autism risk in relation to the growth velocities were obtained using conditional logistic regression. RESULTS Growth velocity of head circumference at 3 months of age, adjusting for gestational age at birth and maternal age, is significantly associated with autism (p = .014); the finding was observed in subjects with comorbid intellectual disability (ID) (p = .025) but not in those without ID (p = .15). Height growth velocity among subjects with autism and without ID is significantly associated with autism at 6 months (p = .007), and weight growth velocity at 18 months without ID (p = .02) and 24 months without ID (p = .042) and with ID (p = .037). CONCLUSIONS Acceleration in head circumference growth is associated with autism with comorbid ID at 3 months but not subsequently. This association is unrelated to acceleration in height and weight, which are not strongly associated with autism until after 6 months.
Collapse
Affiliation(s)
- Ian W McKeague
- Department of Biostatistics, Columbia University Mailman School of Public Health
| | - Alan S Brown
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Yuanyuan Bao
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute
| | | | - Jukka Huttunen
- Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.
| |
Collapse
|
18
|
Oviedo N, Manuel-Apolinar L, de la Chesnaye E, Guerra-Araiza C. [Genetic and neuroendocrine aspects in autism spectrum disorder]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2015; 72:5-14. [PMID: 29421180 DOI: 10.1016/j.bmhimx.2015.01.010] [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: 08/27/2014] [Revised: 12/05/2014] [Accepted: 01/15/2015] [Indexed: 10/23/2022] Open
Abstract
The autism spectrum disorder (ASD) was described in 1943 and is defined as a developmental disorder that affects social interaction and communication. It is usually identified in early stages of development from 18 months of age. Currently, autism is considered a neurological disorder with a spectrum covering cases of different degrees, which is associated with genetic factors, not genetic and environmental. Among the genetic factors, various syndromes have been described that are associated with this disorder. Also, the neurobiology of autism has been studied at the genetic, neurophysiological, neurochemical and neuropathological levels. Neuroimaging techniques have shown multiple structural abnormalities in these patients. There have also been changes in the serotonergic, GABAergic, catecholaminergic and cholinergic systems related to this disorder. This paper presents an update of the information presented in the genetic and neuroendocrine aspects of autism spectrum disorder.
Collapse
Affiliation(s)
- Norma Oviedo
- Unidad de Investigación Médica en Enfermedades Metabólicas, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México
| | - Leticia Manuel-Apolinar
- Unidad de Investigación Médica en Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México
| | - Elsa de la Chesnaye
- Unidad de Investigación Médica en Enfermedades Metabólicas, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México
| | - Christian Guerra-Araiza
- Unidad de Investigación Médica en Farmacología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
| |
Collapse
|
19
|
Williams K, Brignell A, Prior M, Bartak L, Roberts J. Regression in autism spectrum disorders. J Paediatr Child Health 2015; 51:61-4. [PMID: 25586846 DOI: 10.1111/jpc.12805] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2014] [Indexed: 01/01/2023]
Abstract
Since the Journal of Paediatrics and Child Health was first published, there has been substantial change in the field of autism spectrum disorders (ASDs) with an exponential increase in the amount of funded and published research. In this paper, we focus on regression in children with ASD, a phenomenon that remains poorly understood. We discuss the implications of what we know about regression in ASD for the way we think about ASD more broadly and for paediatric practice.
Collapse
Affiliation(s)
- Katrina Williams
- Developmental Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Monash University, Melbourne, Victoria, Australia
| | | | | | | | | |
Collapse
|
20
|
Zwaigenbaum L, Young GS, Stone WL, Dobkins K, Ozonoff S, Brian J, Bryson SE, Carver LJ, Hutman T, Iverson JM, Landa RJ, Messinger D. Early head growth in infants at risk of autism: a baby siblings research consortium study. J Am Acad Child Adolesc Psychiatry 2014; 53:1053-62. [PMID: 25245349 PMCID: PMC4173119 DOI: 10.1016/j.jaac.2014.07.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 07/02/2014] [Accepted: 07/31/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although early brain overgrowth is frequently reported in autism spectrum disorder (ASD), the relationship between ASD and head circumference (HC) is less clear, with inconsistent findings from longitudinal studies that include community controls. Our aim was to examine whether head growth in the first 3 years differed between children with ASD from a high-risk (HR) sample of infant siblings of children with ASD (by definition, multiplex), HR siblings not diagnosed with ASD, and low-risk (LR) controls. METHOD Participants included 442 HR and 253 LR infants from 12 sites of the international Baby Siblings Research Consortium. Longitudinal HC data were obtained prospectively, supplemented by growth records. Random effects nonlinear growth models were used to compare HC in HR infants and LR infants. Additional comparisons were conducted with the HR group stratified by diagnostic status at age 3: ASD (n = 77), developmental delay (DD; n = 32), and typical development (TD; n = 333). Nonlinear growth models were also developed for height to assess general overgrowth associated with ASD. RESULTS There was no overall difference in head circumference growth over the first 3 years between HR and LR infants, although secondary analyses suggested possible increased total growth in HR infants, reflected by the model asymptote. Analyses stratifying the HR group by 3-year outcomes did not detect differences in head growth or height between HR infants who developed ASD and those who did not, nor between infants with ASD and LR controls. CONCLUSION Head growth was uninformative as an ASD risk marker within this HR cohort.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Rebecca J Landa
- Kennedy Krieger Institute and Johns Hopkins School of Medicine, Baltimore
| | | |
Collapse
|
21
|
Neubauer S. Endocasts: possibilities and limitations for the interpretation of human brain evolution. BRAIN, BEHAVIOR AND EVOLUTION 2014; 84:117-34. [PMID: 25247826 DOI: 10.1159/000365276] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Brains are not preserved in the fossil record but endocranial casts are. These are casts of the internal bony braincase, revealing approximate brain size and shape, and they are also informative about brain surface morphology. Endocasts are the only direct evidence of human brain evolution, but they provide only limited data ('paleoneurology'). This review discusses some new fossil endocasts and recent methodological advances that have allowed novel analyses of old endocasts, leading to intriguing findings and hypotheses. The interpretation of paleoneurological data always relies on comparative information from living species whose brains and behavior can be directly investigated. It is therefore important that future studies attempt to better integrate different approaches. Only then will we be able to gain a better understanding about hominin brain evolution. © 2014 S. Karger AG, Basel.
Collapse
Affiliation(s)
- Simon Neubauer
- Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| |
Collapse
|
22
|
Marchese M, Conti V, Valvo G, Moro F, Muratori F, Tancredi R, Santorelli FM, Guerrini R, Sicca F. Autism-epilepsy phenotype with macrocephaly suggests PTEN, but not GLIALCAM, genetic screening. BMC MEDICAL GENETICS 2014; 15:26. [PMID: 24580998 PMCID: PMC3941568 DOI: 10.1186/1471-2350-15-26] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 02/21/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND With a complex and extremely high clinical and genetic heterogeneity, autism spectrum disorders (ASD) are better dissected if one takes into account specific endophenotypes. Comorbidity of ASD with epilepsy (or paroxysmal EEG) has long been described and seems to have strong genetic background. Macrocephaly also represents a well-known endophenotype in subgroups of ASD individuals, which suggests pathogenic mechanisms accelerating brain growth in early development and predisposing to the disorder. We attempted to estimate the association of gene variants with neurodevelopmental disorders in patients with autism-epilepsy phenotype (AEP) and cranial overgrowth, analyzing two genes previously reported to be associated with autism and macrocephaly. METHODS We analyzed the coding sequences and exon-intron boundaries of GLIALCAM, encoding an IgG-like cell adhesion protein, in 81 individuals with Autism Spectrum Disorders, either with or without comorbid epilepsy, paroxysmal EEG and/or macrocephaly, and the PTEN gene in the subsample with macrocephaly. RESULTS Among 81 individuals with ASD, 31 had concurrent macrocephaly. Head circumference, moreover, was over the 99.7th percentile ("extreme" macrocephaly) in 6/31 (19%) patients. Whilst we detected in GLIALCAM several single nucleotide variants without clear pathogenic effects, we found a novel PTEN heterozygous frameshift mutation in one case with "extreme" macrocephaly, autism, intellectual disability and seizures. CONCLUSIONS We did not find a clear association between GLIALCAM mutations and AEP-macrocephaly comorbidity. The identification of a novel frameshift variant of PTEN in a patient with "extreme" macrocephaly, autism, intellectual disability and seizures, confirms this gene as a major candidate in the ASD-macrocephaly endophenotype. The concurrence of epilepsy in the same patient also suggests that PTEN, and the downstream signaling pathway, might deserve to be investigated in autism-epilepsy comorbidity. Working on clinical endophenotypes might be of help to address genetic studies and establish actual causative correlations in autism-epilepsy.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Federico Sicca
- Clinical Neurophysiology Laboratory, IRCCS Stella Maris Foundation, Viale del Tirreno 331, Pisa, Calambrone 56128, Italy.
| |
Collapse
|
23
|
Jones EJH, Gliga T, Bedford R, Charman T, Johnson MH. Developmental pathways to autism: a review of prospective studies of infants at risk. Neurosci Biobehav Rev 2014; 39:1-33. [PMID: 24361967 PMCID: PMC3969297 DOI: 10.1016/j.neubiorev.2013.12.001] [Citation(s) in RCA: 338] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 11/18/2013] [Accepted: 12/02/2013] [Indexed: 02/07/2023]
Abstract
Autism Spectrum Disorders (ASDs) are neurodevelopmental disorders characterized by impairments in social interaction and communication, and the presence of restrictive and repetitive behaviors. Symptoms of ASD likely emerge from a complex interaction between pre-existing neurodevelopmental vulnerabilities and the child's environment, modified by compensatory skills and protective factors. Prospective studies of infants at high familial risk for ASD (who have an older sibling with a diagnosis) are beginning to characterize these developmental pathways to the emergence of clinical symptoms. Here, we review the range of behavioral and neurocognitive markers for later ASD that have been identified in high-risk infants in the first years of life. We discuss theoretical implications of emerging patterns, and identify key directions for future work, including potential resolutions to several methodological challenges for the field. Mapping how ASD unfolds from birth is critical to our understanding of the developmental mechanisms underlying this disorder. A more nuanced understanding of developmental pathways to ASD will help us not only to identify children who need early intervention, but also to improve the range of interventions available to them.
Collapse
Affiliation(s)
- Emily J H Jones
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, UK.
| | - Teodora Gliga
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, UK
| | - Rachael Bedford
- King's College London, Institute of Psychiatry, Department of Biostatistics, UK
| | - Tony Charman
- King's College London, Institute of Psychiatry, Department of Psychology, UK
| | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, UK
| |
Collapse
|
24
|
Barger BD, Campbell JM, McDonough JD. Prevalence and onset of regression within autism spectrum disorders: a meta-analytic review. J Autism Dev Disord 2013; 43:817-28. [PMID: 22855372 DOI: 10.1007/s10803-012-1621-x] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rates and onset of regression were meta-analyzed from 85 articles representing 29,035 participants with autism spectrum disorders (ASD). Overall prevalence rate for regression was 32.1, 95 % CI [29.5, 34.8] occurring at mean of 1.78 years, 95 % CI [1.67, 1.89]. Regression prevalence rates differed according to four types of regression: language regression, 24.9 %; language/social regression, 38.1 %; mixed regression, 32.5 %; and unspecified regression, 39.1 %. Regression prevalence also differed according to sampling method: population-based prevalence was 21.8 %, clinic-based prevalence was 33.6 %, and parent survey-based prevalence was 40.8 %. Risk of regression was equal for males and females, but higher for individuals diagnosed with autism versus another ASD. Later age of regression onset was predicted by older age of child.
Collapse
Affiliation(s)
- Brian D Barger
- Department of Educational Psychology and Instructional Technology, University of Georgia, Athens, GA, USA
| | | | | |
Collapse
|
25
|
Chaste P, Klei L, Sanders SJ, Murtha MT, Hus V, Lowe JK, Willsey AJ, Moreno-De-Luca D, Yu TW, Fombonne E, Geschwind D, Grice DE, Ledbetter DH, Lord C, Mane SM, Martin CL, Martin DM, Morrow EM, Walsh CA, Sutcliffe JS, State MW, Devlin B, Cook EH, Kim SJ. Adjusting head circumference for covariates in autism: clinical correlates of a highly heritable continuous trait. Biol Psychiatry 2013; 74:576-84. [PMID: 23746936 PMCID: PMC3772969 DOI: 10.1016/j.biopsych.2013.04.018] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 03/25/2013] [Accepted: 04/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Brain development follows a different trajectory in children with autism spectrum disorders (ASD) than in typically developing children. A proxy for neurodevelopment could be head circumference (HC), but studies assessing HC and its clinical correlates in ASD have been inconsistent. This study investigates HC and clinical correlates in the Simons Simplex Collection cohort. METHODS We used a mixed linear model to estimate effects of covariates and the deviation from the expected HC given parental HC (genetic deviation). After excluding individuals with incomplete data, 7225 individuals in 1891 families remained for analysis. We examined the relationship between HC/genetic deviation of HC and clinical parameters. RESULTS Gender, age, height, weight, genetic ancestry, and ASD status were significant predictors of HC (estimate of the ASD effect = .2 cm). HC was approximately normally distributed in probands and unaffected relatives, with only a few outliers. Genetic deviation of HC was also normally distributed, consistent with a random sampling of parental genes. Whereas larger HC than expected was associated with ASD symptom severity and regression, IQ decreased with the absolute value of the genetic deviation of HC. CONCLUSIONS Measured against expected values derived from covariates of ASD subjects, statistical outliers for HC were uncommon. HC is a strongly heritable trait, and population norms for HC would be far more accurate if covariates including genetic ancestry, height, and age were taken into account. The association of diminishing IQ with absolute deviation from predicted HC values suggests HC could reflect subtle underlying brain development and warrants further investigation.
Collapse
Affiliation(s)
- Pauline Chaste
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA, FondaMental Foundation, Créteil, France
| | - Lambertus Klei
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Stephan J. Sanders
- Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, USA, Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA, Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael T. Murtha
- Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Vanessa Hus
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer K. Lowe
- Neurogenetics Program, Department of Neurology and Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - A. Jeremy Willsey
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Daniel Moreno-De-Luca
- Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, USA, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Timothy W. Yu
- Division of Genetics, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Daniel Geschwind
- Neurogenetics Program, Department of Neurology and Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Dorothy E. Grice
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, USA
| | | | - Catherine Lord
- Center for Autism and the Developing Brain, Weill Cornell Medical College, White Plains, New York, USA
| | | | - Christa Lese Martin
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Donna M. Martin
- Departments of Pediatrics and Human Genetics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Eric M. Morrow
- Department of Molecular Biology, Cell Biology and Biochemistry; and Institute for Brain Science, Brown University, Lab for Molecular Medicine, Providence, Rhode Island, USA, Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital and Department of Psychiatry and Human Behavior, Brown University Medical School, East Providence, Rhode Island, USA
| | - Christopher A. Walsh
- Howard Hughes Medical Institute and Division of Genetics, Children's Hospital Boston, and Neurology and Pediatrics, Harvard Medical School Center for Life Sciences, Boston, Massachusetts, USA
| | - James S. Sutcliffe
- Departments of Molecular Physiology & Biophysics and Psychiatry, Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Matthew W. State
- Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, USA, Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA, Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Bernie Devlin
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Edwin H. Cook
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Soo-Jeong Kim
- Center for Integrative Brain Research, Seattle Children's Research Institute & Department of Psychiatry and Behavioral Science, University of Washington, Seattle, WA, USA,Corresponding author Soo-Jeong Kim, M.D., Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 9 Ave, Seattle, WA 98101, USA, , Tel: +12068841275, Fax:+12068841210
| |
Collapse
|
26
|
Raznahan A, Wallace GL, Antezana L, Greenstein D, Lenroot R, Thurm A, Gozzi M, Spence S, Martin A, Swedo SE, Giedd JN. Compared to what? Early brain overgrowth in autism and the perils of population norms. Biol Psychiatry 2013; 74:563-75. [PMID: 23706681 PMCID: PMC4837958 DOI: 10.1016/j.biopsych.2013.03.022] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 02/27/2013] [Accepted: 03/13/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Early brain overgrowth (EBO) in autism spectrum disorder (ASD) is among the best replicated biological associations in psychiatry. Most positive reports have compared head circumference (HC) in ASD (an excellent proxy for early brain size) with well-known reference norms. We sought to reappraise evidence for the EBO hypothesis given 1) the recent proliferation of longitudinal HC studies in ASD, and 2) emerging reports that several of the reference norms used to define EBO in ASD may be biased toward detecting HC overgrowth in contemporary samples of healthy children. METHODS Systematic review of all published HC studies in children with ASD. Comparison of 330 longitudinally gathered HC measures between birth and 18 months from male children with autism (n = 35) and typically developing control subjects (n = 22). RESULTS In systematic review, comparisons with locally recruited control subjects were significantly less likely to identify EBO in ASD than norm-based studies (p < .001). Through systematic review and analysis of new data, we replicate seminal reports of EBO in ASD relative to classical HC norms but show that this overgrowth relative to norms is mimicked by patterns of HC growth age in a large contemporary community-based sample of US children (n ~ 75,000). Controlling for known HC norm biases leaves inconsistent support for a subtle, later emerging and subgroup specific pattern of EBO in clinically ascertained ASD versus community control subjects. CONCLUSIONS The best-replicated aspects of EBO reflect generalizable HC norm biases rather than disease-specific biomarkers. The potential HC norm biases we detail are not specific to ASD research but apply throughout clinical and academic medicine.
Collapse
Affiliation(s)
- Armin Raznahan
- Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
| | | | - Ligia Antezana
- Laboratory of Brain and Cognition, NIMH, NIH, Bethesda, MD, USA
| | | | - Rhoshel Lenroot
- Department of Psychiatry, University of New South Wales, Sydney, Australia
| | - Audrey Thurm
- Pediatric Developmental Neurosciences Branch, NIMH, NIH, Bethesda, MD, USA
| | - Marta Gozzi
- Pediatric Developmental Neurosciences Branch, NIMH, NIH, Bethesda, MD, USA
| | - Sarah Spence
- Department of Neurology, Children’s Hospital Boston, Harvard Medical School, MA, USA
| | - Alex Martin
- Laboratory of Brain and Cognition, NIMH, NIH, Bethesda, MD, USA
| | - Susan E Swedo
- Pediatric Developmental Neurosciences Branch, NIMH, NIH, Bethesda, MD, USA
| | - Jay N Giedd
- Child Psychiatry Branch, NIMH, NIH, Bethesda, MD, USA
| |
Collapse
|
27
|
Surén P, Stoltenberg C, Bresnahan M, Hirtz D, Lie KK, Lipkin WI, Magnus P, Reichborn-Kjennerud T, Schjølberg S, Susser E, Oyen AS, Li L, Hornig M. Early growth patterns in children with autism. Epidemiology 2013; 24:660-70. [PMID: 23867813 PMCID: PMC3749377 DOI: 10.1097/ede.0b013e31829e1d45] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Case-control studies have found increased head growth during the first year of life in children with autism spectrum disorder. Length and weight have not been as extensively studied, and there are few studies of population-based samples. METHODS The study was conducted in a sample of 106,082 children from the population-based Norwegian Mother and Child Cohort. The children were born in 1999-2009; by the end of follow-up on 31 December 2012, the age range was 3.6 through 13.1 years (mean 7.4 years). Measures were obtained prospectively until age 12 months for head circumference and 36 months for length and weight. We compared growth trajectories in autism spectrum disorder cases and noncases using Reed first-order models. RESULTS Subjects included 376 children (310 boys and 66 girls) with specialist-confirmed autism spectrum disorder. In boys with autism spectrum disorder, mean head growth was similar to that of other boys, but variability was greater, and 8.7% had macrocephaly (head circumference > 97th cohort percentile) by 12 months of age. Autism spectrum disorder boys also had slightly increased body growth, with mean length 1.1 cm above and mean weight 300 g above the cohort mean for boys at age 12 months. Throughout the first year, the head circumference of girls with autism spectrum disorder was reduced-by 0.3 cm at birth and 0.5 cm at 12 months. Their mean length was similar to that of other girls, but their mean weight was 150-350 g below at all ages from birth to 3 years. The reductions in mean head circumference and weight in girls with autism spectrum disorder appear to be driven by those with intellectual disability, genetic disorders, and epilepsy. DISCUSSION Growth trajectories in children with autism spectrum disorder diverge from those of other children and the differences are sex specific. Previous findings of increased mean head growth were not replicated.
Collapse
Affiliation(s)
- Pål Surén
- Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, United Kingdom.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Ben-Itzchak E, Ben-Shachar S, Zachor DA. Specific Neurological Phenotypes in Autism Spectrum Disorders Are Associated with Sex Representation. Autism Res 2013; 6:596-604. [DOI: 10.1002/aur.1319] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 06/17/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Esther Ben-Itzchak
- Department of Communication Disorders; Ariel University Center of Samaria; Ariel Israel
- The Autism Center, Department of Pediatrics; Assaf Harofeh Medical Center; Zerifin Israel
| | - Shay Ben-Shachar
- The Genetic Institute; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel
| | - Ditza A. Zachor
- The Autism Center, Department of Pediatrics; Assaf Harofeh Medical Center; Zerifin Israel
- Tel Aviv University; Tel-Aviv Israel
| |
Collapse
|
29
|
Insulin-like growth factor and the etiology of autism. Med Hypotheses 2013; 80:475-80. [DOI: 10.1016/j.mehy.2013.01.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 01/09/2013] [Indexed: 11/24/2022]
|
30
|
Dickstein DP, Pescosolido MF, Reidy BL, Galvan T, Kim KL, Seymour KE, Laird AR, Di Martino A, Barrett RP. Developmental meta-analysis of the functional neural correlates of autism spectrum disorders. J Am Acad Child Adolesc Psychiatry 2013; 52:279-289.e16. [PMID: 23452684 PMCID: PMC5441228 DOI: 10.1016/j.jaac.2012.12.012] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 11/26/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE There is a pressing need to elucidate the brain-behavior interactions underlying autism spectrum disorders (ASD) given the marked rise in ASD diagnosis over the past decade. Functional magnetic resonance imaging (fMRI) has begun to address this need, but few fMRI studies have evaluated age-related changes in ASD. Therefore, we conducted a developmental analysis of activation likelihood estimation (ALE) meta-analysis to compare child versus adult ASD fMRI studies. We hypothesized that children and adolescents with ASD (<18 years old) would rely less on prefrontal cortex structures than adults (≥18 years old). METHOD PubMed and PsycInfo literature searches were conducted to identify task-dependent fMRI studies of children or adults with ASD. Then recent GingerALE software improvements were leveraged to perform direct comparisons of child (n = 18) versus adult (n = 24) studies. RESULTS ALE meta-analyses of social tasks showed that children and adolescents with ASD versus adults had significantly greater hyperactivation in the left post-central gyrus, and greater hypoactivation in the right hippocampus and right superior temporal gyrus. ALE meta-analyses of nonsocial tasks showed that children with ASD versus adults had significantly greater hyperactivation in the right insula and left cingulate gyrus, and hypoactivation in the right middle frontal gyrus. CONCLUSION Our data suggest that the neural alterations associated with ASD are not static, occurring only in early childhood. Instead, children with ASD have altered neural activity compared to adults during both social and nonsocial tasks, especially in fronto-temporal structures. Longitudinal neuroimaging studies are required to examine these changes prospectively, as potential targets for brain-based treatments for ASD.
Collapse
Affiliation(s)
- Daniel P. Dickstein
- Bradley Hospital’s PediMIND Program and the Alpert Medical School of Brown University
| | | | - Brooke L. Reidy
- Bradley Hospital’s PediMIND Program and the Alpert Medical School of Brown University
| | - Thania Galvan
- Bradley Hospital’s PediMIND Program and the Alpert Medical School of Brown University
| | - Kerri L. Kim
- Bradley Hospital’s PediMIND Program and the Alpert Medical School of Brown University
| | - Karen E. Seymour
- Bradley Hospital’s PediMIND Program and the Alpert Medical School of Brown University
| | | | | | - Rowland P. Barrett
- Bradley Hospital’s Center for Autism and Developmental Disabilities and the Alpert Medical School of Brown University
| |
Collapse
|
31
|
Landa RJ, Gross AL, Stuart EA, Faherty A. Developmental trajectories in children with and without autism spectrum disorders: the first 3 years. Child Dev 2013; 84:429-42. [PMID: 23110514 PMCID: PMC4105265 DOI: 10.1111/j.1467-8624.2012.01870.x] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Retrospective studies indicate 2 major classes of autism spectrum disorder (ASD) onset: early and later, after a period of relatively healthy development. This prospective, longitudinal study examined social, language, and motor trajectories in 235 children with and without a sibling with autism, ages 6-36 months. Children were grouped as: ASD identified by 14 months, ASD identified after 14 months, and no ASD. Despite groups' initial similar developmental level at 6 months, ASD groups exhibited atypical trajectories thereafter. Impairment from 14 to 24 months was greater in the Early-ASD than the Later-ASD group, but comparable at 36 months. Developmental plateau and regression occurred in some children with ASD, regardless of timing of ASD diagnosis. Findings indicate a preclinical phase of varying duration for ASD.
Collapse
|
32
|
Gray KM, Taffe J, Sweeney DJ, Forster S, Tonge BJ. Could head circumference be used to screen for autism in young males with developmental delay? J Paediatr Child Health 2012; 48:329-34. [PMID: 22077913 DOI: 10.1111/j.1440-1754.2011.02238.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Research has suggested an abnormal acceleration in head circumference growth in children with autism within the first 12 months of life. This study aimed to examine head circumference at birth and head circumference growth rates in young children with autism and developmental delay, and young children with developmental delay without autism. METHODS This study assessed head circumference at birth and rate of change in head circumference in young children with autism (n=86) and children with developmental delay without autism (n=40). RESULTS For both groups of children, head circumference at birth and head circumference growth were compared with Centers for Disease Control normative data. No differences were found between the group of children with autism and developmental delay compared with the group with developmental delay only. However, when the sample was compared with a range of selected Centers for Disease Control normative medians, the children with autism were found to have significantly smaller head circumferences at birth and significantly larger head circumference at 18.5 months of age. CONCLUSIONS These results are discussed in relation to the potential of accelerated head circumference growth as an early marker for autism. This study failed to find a difference in the head circumferences of children with autism and developmental delay and children with developmental delay only, thus suggesting that head circumference measurement has limited value as an early marker for autism.
Collapse
Affiliation(s)
- Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, School of Psychology and Psychiatry, Monash University, Melbourne, Victoria, Australia.
| | | | | | | | | |
Collapse
|
33
|
Morgan JT, Chana G, Abramson I, Semendeferi K, Courchesne E, Everall IP. Abnormal microglial-neuronal spatial organization in the dorsolateral prefrontal cortex in autism. Brain Res 2012; 1456:72-81. [PMID: 22516109 DOI: 10.1016/j.brainres.2012.03.036] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 03/08/2012] [Accepted: 03/15/2012] [Indexed: 12/27/2022]
Abstract
Microglial activation and alterations in neuron number have been reported in autism. However, it is unknown whether microglial activation in the disorder includes a neuron-directed microglial response that might reflect neuronal dysfunction, or instead indicates a non-directed, pro-activation brain environment. To address this question, we examined microglial and neuronal organization in the dorsolateral prefrontal cortex, a region of pronounced early brain overgrowth in autism, via spatial pattern analysis of 13 male postmortem autism subjects and 9 controls. We report that microglia are more frequently present near neurons in the autism cases at a distance interval of 25 μm, as well as 75 and 100 μm. Many interactions are observed between near-distance microglia and neurons that appear to involve encirclement of the neurons by microglial processes. Analysis of a young subject subgroup preliminarily suggests that this alteration may be present from an early age in autism. We additionally observed that neuron-neuron clustering, although normal in cases with autism as a whole, increases with advancing age in autism, suggesting a gradual loss of normal neuronal organization in the disorder. Microglia-microglia organization is normal in autism at all ages, indicating that aberrantly close microglia-neuron association in the disorder is not a result of altered microglial distribution. Our findings confirm that at least some microglial activation in the dorsolateral prefrontal cortex in autism is associated with a neuron-specific reaction, and suggest that neuronal organization may degrade later in life in the disorder.
Collapse
Affiliation(s)
- John T Morgan
- Department of Neuroscience, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0602, USA.
| | | | | | | | | | | |
Collapse
|
34
|
Gamliel M, Ebstein R, Yirmiya N, Mankuta D. Minor Fetal Sonographic Findings in Autism Spectrum Disorder. Obstet Gynecol Surv 2012; 67:176-86. [DOI: 10.1097/ogx.0b013e31824bb5d6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
35
|
|
36
|
Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders. Proc Natl Acad Sci U S A 2011; 108:20195-200. [PMID: 22123952 DOI: 10.1073/pnas.1107560108] [Citation(s) in RCA: 174] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Autism is a heterogeneous disorder with multiple behavioral and biological phenotypes. Accelerated brain growth during early childhood is a well-established biological feature of autism. Onset pattern, i.e., early onset or regressive, is an intensely studied behavioral phenotype of autism. There is currently little known, however, about whether, or how, onset status maps onto the abnormal brain growth. We examined the relationship between total brain volume and onset status in a large sample of 2- to 4-y-old boys and girls with autism spectrum disorder (ASD) [n = 53, no regression (nREG); n = 61, regression (REG)] and a comparison group of age-matched typically developing controls (n = 66). We also examined retrospective head circumference measurements from birth through 18 mo of age. We found that abnormal brain enlargement was most commonly found in boys with regressive autism. Brain size in boys without regression did not differ from controls. Retrospective head circumference measurements indicate that head circumference in boys with regressive autism is normal at birth but diverges from the other groups around 4-6 mo of age. There were no differences in brain size in girls with autism (n = 22, ASD; n = 24, controls). These results suggest that there may be distinct neural phenotypes associated with different onsets of autism. For boys with regressive autism, divergence in brain size occurs well before loss of skills is commonly reported. Thus, rapid head growth may be a risk factor for regressive autism.
Collapse
|
37
|
Fujisawa KK, Ozaki K, Suzuki K, Yamagata S, Kawahashi I, Ando J. Genetic and environmental relationships between head circumference growth in the first year of life and sociocognitive development in the second year: a longitudinal twin study. Dev Sci 2011; 15:99-112. [DOI: 10.1111/j.1467-7687.2011.01097.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
38
|
Angkustsiri K, Krakowiak P, Moghaddam B, Wardinsky T, Gardner J, Kalamkarian N, Hertz-Picciotto I, Hansen RL. Minor physical anomalies in children with autism spectrum disorders. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2011; 15:746-60. [PMID: 21610186 PMCID: PMC4245022 DOI: 10.1177/1362361310397620] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE There is clinical heterogeneity among the autism spectrum disorders (ASD). The presence of dysmorphology (minor physical anomalies; MPAs) is one possible tool for defining a clinically relevant subset in ASD. This study employs an adaptation of Miles and Hillman's (2000) classifications by using photographs to identify a subgroup with significant dysmorphology among children with ASD, typical development (TYP), and developmental delay (DD). METHOD Children with ASD, DD, and TYP between 2 and 5 years old were part of the CHARGE Study. Pediatric specialists blinded to diagnostic group classified photographs based on the number of MPAs present: 'dysmorphic' if >3 and 'nondysmorphic' if <3 MPAs. RESULTS Photographs for 324 children were included. Significantly more children with ASD were classified as dysmorphic compared to TYP children (p = .007). In children with ASD, seizures were more prevalent in those rated dysmorphic (p = .005). Frequencies were similar between ASD versus DD (p = .19) after removing those with known syndromes. CONCLUSION Photographic assessment can be used to detect generalized dysmorphology in children who are often difficult to examine. This has clinical relevance, as children with multiple MPAs can be identified through the use of photographs and prioritized for investigation of brain abnormalities and underlying genetic disorders.
Collapse
|
39
|
Head circumference and body growth in autism spectrum disorders. Brain Dev 2011; 33:569-75. [PMID: 20934821 DOI: 10.1016/j.braindev.2010.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 09/10/2010] [Accepted: 09/10/2010] [Indexed: 01/22/2023]
Abstract
Research has shown that there is a relationship between increased head circumference and autism spectrum disorders (ASD). This study examined this relationship during the first year of life in subjects with ASD. We compared 280 children with ASD and 609 controls. In the ASD-male group, increases were observed in head circumference from 3 to 12months, in height from 3 to 9months, and in body weight from 3 to 6 and 12months. On the other hand, in the ASD-female group increases in head circumference, in body height, and in body weight were only observed at 3months. After adjusting for height, weight, and age, only the head circumference in the male ASD group was significantly increased from 6 to 9months after birth, reaching a peak at 6months after birth. No difference was found in the female ASD group. Although body overgrowth in the ASD group also started early after birth, the increase in head circumference was more marked than that in body growth. The values of physical measurements in the first year may be useful, minimally invasive parameters for the early detection of autism in combination with observing the timing of certain behaviors such as smiling, eye contact, crawling, pointing, and joint attention.
Collapse
|
40
|
Davidovitch M, Golan D, Vardi O, Lev D, Lerman-Sagie T. Israeli children with autism spectrum disorder are not macrocephalic. J Child Neurol 2011; 26:580-5. [PMID: 21464237 DOI: 10.1177/0883073810387666] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The prevalence of macrocephaly in autism spectrum disorder is reported to be much higher than in the general population, 12% to 37%. Progressive macrocephaly is even considered a warning sign for the development of autism. We evaluated the prevalence of an abnormal head circumference in children with autism in Israel and compared it with the head circumferences of children with developmental language disorder and children with normal development. We did not find a higher prevalence of macrocephaly among Israeli children with autism spectrum disorder (4.4%). Although children with autism spectrum disorder had a significantly higher rate of a head circumference above the 75th percentile compared with children with developmental language disorder, it was not significantly different compared with normal controls. We conclude that there is no increased prevalence of macrocephaly in Israeli children with autism; this can be attributed to a different genetic background.
Collapse
Affiliation(s)
- Michael Davidovitch
- Child Development Center, Jerusalem and Shfela District, Maccabi Healthcare Services, Israel.
| | | | | | | | | |
Collapse
|
41
|
Rommelse NNJ, Peters CTR, Oosterling IJ, Visser JC, Bons D, van Steijn DJ, Draaisma J, van der Gaag RJ, Buitelaar JK. A pilot study of abnormal growth in autism spectrum disorders and other childhood psychiatric disorders. J Autism Dev Disord 2011; 41:44-54. [PMID: 20428954 PMCID: PMC3005115 DOI: 10.1007/s10803-010-1026-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aims of the current study were to examine whether early growth abnormalities are (a) comparable in autism spectrum disorders (ASD) and other childhood psychiatric disorders, and (b) specific to the brain or generalized to the whole body. Head circumference, height, and weight were measured during the first 19 months of life in 129 children with ASD and 59 children with non-ASD psychiatric disorders. Both groups showed comparable abnormal patterns of growth compared to population norms, especially regarding height and head circumference in relation to height. Thus abnormal growth appears to be related to psychiatric disorders in general and is mainly expressed as an accelerated growth of height not matched by an increase in weight or head circumference.
Collapse
Affiliation(s)
- Nanda N J Rommelse
- Karakter, Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Courchesne E, Campbell K, Solso S. Brain growth across the life span in autism: age-specific changes in anatomical pathology. Brain Res 2011; 1380:138-45. [PMID: 20920490 PMCID: PMC4500507 DOI: 10.1016/j.brainres.2010.09.101] [Citation(s) in RCA: 420] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 09/22/2010] [Accepted: 09/25/2010] [Indexed: 01/25/2023]
Abstract
Autism is marked by overgrowth of the brain at the earliest ages but not at older ages when decreases in structural volumes and neuron numbers are observed instead. This has led to the theory of age-specific anatomic abnormalities in autism. Here we report age-related changes in brain size in autistic and typical subjects from 12 months to 50 years of age based on analyses of 586 longitudinal and cross-sectional MRI scans. This dataset is several times larger than the largest autism study to date. Results demonstrate early brain overgrowth during infancy and the toddler years in autistic boys and girls, followed by an accelerated rate of decline in size and perhaps degeneration from adolescence to late middle age in this disorder. We theorize that underlying these age-specific changes in anatomic abnormalities in autism, there may also be age-specific changes in gene expression, molecular, synaptic, cellular, and circuit abnormalities. A peak age for detecting and studying the earliest fundamental biological underpinnings of autism is prenatal life and the first three postnatal years. Studies of the older autistic brain may not address original causes but are essential to discovering how best to help the older aging autistic person. Lastly, the theory of age-specific anatomic abnormalities in autism has broad implications for a wide range of work on the disorder including the design, validation, and interpretation of animal model, lymphocyte gene expression, brain gene expression, and genotype/CNV-anatomic phenotype studies.
Collapse
Affiliation(s)
- Eric Courchesne
- Department of Neuroscience, Autism Center of Excellence, University of California, San Diego, CA, USA.
| | | | | |
Collapse
|
43
|
Charman T, Jones CRG, Pickles A, Simonoff E, Baird G, Happé F. Defining the cognitive phenotype of autism. Brain Res 2010; 1380:10-21. [PMID: 21029728 DOI: 10.1016/j.brainres.2010.10.075] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 10/18/2010] [Accepted: 10/19/2010] [Indexed: 01/21/2023]
Abstract
Although much progress has been made in determining the cognitive profile of strengths and weaknesses that characterise individuals with autism spectrum disorders (ASDs), there remain a number of outstanding questions. These include how universal strengths and deficits are; whether cognitive subgroups exist; and how cognition is associated with core autistic behaviours, as well as associated psychopathology. Several methodological factors have contributed to these limitations in our knowledge, including: small sample sizes, a focus on single domains of cognition, and an absence of comprehensive behavioural phenotypic information. To attempt to overcome some of these limitations, we assessed a wide range of cognitive domains in a large sample (N=100) of 14- to 16-year-old adolescents with ASDs who had been rigorously behaviourally characterised. In this review, we will use examples of some initial findings in the domains of perceptual processing, emotion processing and memory, both to outline different approaches we have taken to data analysis and to highlight the considerable challenges to better defining the cognitive phenotype(s) of ASDs. Enhanced knowledge of the cognitive phenotype may contribute to our understanding of the complex links between genes, brain and behaviour, as well as inform approaches to remediation.
Collapse
Affiliation(s)
- T Charman
- Centre for Research in Autism and Education, Department of Psychology and Human Development, Institute of Education, London, UK.
| | | | | | | | | | | |
Collapse
|
44
|
Autism in adults. New biologicial findings and their translational implications to the cost of clinical services. Brain Res 2010; 1380:22-33. [PMID: 20969835 DOI: 10.1016/j.brainres.2010.10.042] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/22/2010] [Accepted: 10/13/2010] [Indexed: 11/21/2022]
Abstract
There is increasing evidence that children with autism spectrum disorder (ASD) have differences in brain growth trajectory. However, the neurobiological basis of ASD in adults is poorly understood. We report evidence that brain anatomy and aging in people with ASD is significantly different as compared to controls-so that in adulthood they no longer have a significantly larger overall brain volume, but they do have anatomical and functional abnormalities in frontal lobe, basal ganglia and the limbic system. Further we present preliminary evidence that females have significantly greater abnormalities in brain than males to express the same symptom severity of ASD (i.e. the female brain is "protective" against developing ASD). Also we present preliminary evidence that, in adults, clinical services for autism in the United Kingdom are experiencing very significantly increased demand; but that just over 50% of people seeking a diagnosis from one expert service do not have ASD. This consumes very significant health care resources, and so we need to identify new cost-effective methods to aid current diagnostic practice. We present initial evidence offering proof of concept that brain anatomy can be used to accurately distinguish adults with autism from healthy controls, and from some other neurodevelopmental disorders (ADHD). Hence further studies are required to determine if sMRI can become an aid to current diagnostic practice in young adults with ASD. Lastly we report evidence that differences in serotonin, glutamate and GABA may partially explain neuroanatomical and neurofunctional abnormalities in people with ASD, and that genetic influences on brain maturation vary across the lifespan (with 5-HT transporter polymorphisms having significant modulatory effects in children but not adults).
Collapse
|
45
|
Longitudinal magnetic resonance imaging study of cortical development through early childhood in autism. J Neurosci 2010; 30:4419-27. [PMID: 20335478 DOI: 10.1523/jneurosci.5714-09.2010] [Citation(s) in RCA: 374] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cross-sectional magnetic resonance imaging (MRI) studies have long hypothesized that the brain in children with autism undergoes an abnormal growth trajectory that includes a period of early overgrowth; however, this has never been confirmed by a longitudinal study. We performed the first longitudinal study of brain growth in toddlers at the time symptoms of autism are becoming clinically apparent using structural MRI scans at multiple time points beginning at 1.5 years up to 5 years of age. We collected 193 scans on 41 toddlers who received a confirmed diagnosis of autistic disorder at approximately 48 months of age and 44 typically developing controls. By 2.5 years of age, both cerebral gray and white matter were significantly enlarged in toddlers with autistic disorder, with the most severe enlargement occurring in frontal, temporal, and cingulate cortices. In the longitudinal analyses, which we accounted for age and gender effect, we found that all regions (cerebral gray, cerebral white, frontal gray, temporal gray, cingulate gray, and parietal gray) except occipital gray developed at an abnormal growth rate in toddlers with autistic disorder that was mainly characterized by a quadratic age effect. Females with autistic disorder displayed a more pronounced abnormal growth profile in more brain regions than males with the disorder. Given that overgrowth clearly begins before 2 years of age, future longitudinal studies would benefit from inclusion of even younger populations as well as further characterization of genetic and other biomarkers to determine the underlying neuropathological processes causing the onset of autistic symptoms.
Collapse
|
46
|
Yirmiya N, Charman T. The prodrome of autism: early behavioral and biological signs, regression, peri- and post-natal development and genetics. J Child Psychol Psychiatry 2010; 51:432-58. [PMID: 20085609 DOI: 10.1111/j.1469-7610.2010.02214.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Autism is one of the most heritable neurodevelopmental conditions and has an early onset, with symptoms being required to be present in the first 3 years of life in order to meet criteria for the 'core' disorder in the classification systems. As such, the focus on identifying a prodrome over the past 20 years has been on pre-clinical signs or indicators that will be present very early in life, certainly in infancy. A number of novel lines of investigation have been used to this end, including retrospective coding of home videos, prospective population screening and 'high risk' sibling studies; as well as the investigation of pre- and peri-natal, brain developmental and other biological factors. While no single prodromal sign is expected to be present in all cases, a picture is emerging of indicative prodromal signs in infancy and initial studies are being undertaken to attempt to ameliorate early presentation and even 'prevent' emergence of the full syndrome.
Collapse
Affiliation(s)
- Nurit Yirmiya
- Department of Psychology and School of Education, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel 91905.
| | | |
Collapse
|
47
|
Constantino JN, Majmudar P, Bottini A, Arvin M, Virkud Y, Simons P, Spitznagel E. Infant head growth in male siblings of children with and without autism spectrum disorders. J Neurodev Disord 2009; 2:39-46. [PMID: 20651949 PMCID: PMC2908031 DOI: 10.1007/s11689-009-9036-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Previous research has indicated that children with autism exhibit accelerated head growth (HG) in infancy, although the timing of acceleration varies between studies. We examined infant HG trajectory as a candidate autism endophenotype by studying sibling pairs. We retrospectively obtained serial head orbitofrontal circumference measurements of: a) 48 sibling pairs in which one (n = 28) or both (n = 20) sibs were affected by an autism spectrum disorder (ASD); and b) 85 control male sibling pairs. Rate of HG of ASD subjects was slightly accelerated compared to controls, but the magnitude of difference was below the limit of reliability of standard measurement methods. Sibling intra class correlation for rate of HG was highly statistically significant; the magnitude was significantly stronger among autism-affected families (ICC = .63) than among controls (ICC = .26), p < .01. Infant HG trajectory appears familial—possibly endophenotypic—but was not a reliable marker of autism risk among siblings of ASD probands in this sample.
Collapse
Affiliation(s)
- John N Constantino
- Departments of Psychiatry and Pediatrics, Washington University, Saint. Louis, Missouri
| | | | | | | | | | | | | |
Collapse
|
48
|
Raznahan A, Toro R, Daly E, Robertson D, Murphy C, Deeley Q, Bolton PF, Paus T, Murphy DGM. Cortical Anatomy in Autism Spectrum Disorder: An In Vivo MRI Study on the Effect of Age. Cereb Cortex 2009; 20:1332-40. [PMID: 19819933 DOI: 10.1093/cercor/bhp198] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Armin Raznahan
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Mraz KD, Dixon J, Dumont-Mathieu T, Fein D. Accelerated head and body growth in infants later diagnosed with autism spectrum disorders: a comparative study of optimal outcome children. J Child Neurol 2009; 24:833-45. [PMID: 19617459 DOI: 10.1177/0883073808331345] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research has demonstrated accelerated head and body growth during infancy in children with autism spectrum disorders. No study has yet examined head growth in children who lose their autism spectrum disorder diagnoses. Head circumference, length, and weight growth during infancy for 24 children who maintained their diagnoses were compared with 15 children who lost their diagnoses, and to 37 typically developing controls. Results showed that head circumference and weight growth were significantly greater in both autism spectrum disorder groups compared with controls, with no significant differences between autism spectrum disorder groups. However, when length and weight were controlled for, accelerated head growth remained significant in the children who lost their diagnoses. Findings suggest that children who lose their autism spectrum disorder diagnoses and children who maintain their diagnoses show similar head circumference, length, and weight growth trajectories during infancy, although subtle differences in body growth between groups may exist.
Collapse
Affiliation(s)
- Krista D Mraz
- Department of Psychology, University of Connecticut, Connecticut, USA.
| | | | | | | |
Collapse
|
50
|
Webb SJ, Jones EJH. Early Identification of Autism: Early Characteristics, Onset of Symptoms, and Diagnostic Stability. INFANTS AND YOUNG CHILDREN 2009; 22:100-118. [PMID: 28090148 PMCID: PMC5232420 DOI: 10.1097/iyc.0b013e3181a02f7f] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In the first year of life, infants who later go on to develop autistic spectrum disorders (ASD) may exhibit subtle disruptions in social interest and attention, communication, temperament, and head circumference growth that occur prior to the onset of clinical symptoms. These disruptions may reflect the early course of ASD development and may also contribute to the later development of clinical symptoms through alterations in the child's experience of his or her environment. By age 2, developmental precursors of autism symptoms can be used to diagnose children reliably, and by age 3, the diagnosis is thought to be relatively stable. The downward extension of the autism diagnosis poses important questions for therapists in designing interventions that are applicable for infants who demonstrate early risk factors. We review current knowledge of the early signs of ASD in the infancy period (0-12 months) and the manifestation of symptoms in toddlerhood (12- 36 months), noting the importance of considering the variability in onset and trajectory of ASD. Finally, we consider the implications of this emerging research for those who work or interact with young children, including the importance of early monitoring and the development and evaluation of age-appropriate interventions.
Collapse
Affiliation(s)
- Sara Jane Webb
- Department of Psychiatry and Behavioral Sciences, University of Washington Autism Center, University of Washington, Seattle
| | - Emily J H Jones
- Department of Psychiatry and Behavioral Sciences, University of Washington Autism Center, University of Washington, Seattle
| |
Collapse
|