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Franz L, Goodwin CD, Rieder A, Matheis M, Damiano DL. Early intervention for very young children with or at high likelihood for autism spectrum disorder: An overview of reviews. Dev Med Child Neurol 2022; 64:1063-1076. [PMID: 35582893 PMCID: PMC9339513 DOI: 10.1111/dmcn.15258] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022]
Abstract
AIM To identify which interventions are supported by evidence and the quality of that evidence in very young children with or at high likelihood for autism spectrum disorder (ASD) to improve child outcomes. METHOD We conducted an overview of reviews to synthesize early intervention literature for very young children with or at high likelihood for ASD. Cochrane guidance on how to perform overviews of reviews was followed. Comprehensive searches of databases were conducted for systematic reviews and meta-analyses between January 2009 and December 2020. Review data were extracted and summarized and methodological quality was assessed. Primary randomized controlled trial evidence was summarized and risk of bias assessed. This overview of reviews was not registered. RESULTS From 762 records, 78 full texts were reviewed and seven systematic reviews and meta-analyses with 63 unique studies were identified. Several interventional approaches (naturalistic developmental behavioral intervention, and developmental and behavioral interventions) improved child developmental outcomes. Heterogeneity in design, intervention and control group, dose, delivery agent, and measurement approach was noted. Inconsistent methodological quality and potential biases were identified. INTERPRETATION While many early interventional approaches have an impact on child outcomes, study heterogeneity and quality had an impact on our ability to draw firm conclusions regarding which treatments are most effective. Advances in trial methodology and design, and increasing attention to mitigating measurement bias, will advance the quality of the ASD early intervention evidence base. WHAT THIS PAPER ADDS Naturalistic developmental behavioral interventions, as well as developmental and behavioral interventions, improve child outcomes in autism spectrum disorder (ASD). If only randomized controlled trials are considered, guidelines for early intensive behavioral intervention in younger children should be revisited. The greatest intervention impacts were on proximal, intervention-specific outcomes. Inadequacies in the quality of the early ASD intervention evidence base were observed.
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Affiliation(s)
- Lauren Franz
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke Global Health Institute, Duke University, Durham, NC, USA
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, Cape Town, South Africa
| | | | - Amber Rieder
- Duke Global Health Institute, Duke Institute for Brain Sciences, Duke University, Durham, NC, USA
| | - Maya Matheis
- Center on Disability Studies, College of Education, University of Hawai’i at Mānoa, Honolulu, Hawai’i, USA
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2
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Spadacenta S, Dicke PW, Thier P. A prosocial function of head-gaze aversion and head-cocking in common marmosets. Primates 2022; 63:535-546. [PMID: 35838928 PMCID: PMC9463209 DOI: 10.1007/s10329-022-00997-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/17/2022] [Indexed: 11/24/2022]
Abstract
Gaze aversion is a behavior adopted by several mammalian and non-mammalian species in response to eye contact, and is usually interpreted as a reaction to a perceived threat. Unlike many other primate species, common marmosets (Callithrix jacchus) are thought to have a high tolerance for direct gaze, barely exhibiting gaze avoidance towards conspecifics and humans. Here we show that this does not hold for marmosets interacting with a familiar experimenter who suddenly establishes eye contact in a playful interaction (peekaboo). Video footage synchronously recorded from the perspective of the marmoset and the experimenter showed that the monkeys consistently alternated between eye contact and head-gaze aversion, and that these responses were often preceded by head-cocking. We hypothesize that this behavioral strategy helps marmosets to temporarily disengage from emotionally overwhelming social stimulation due to sight of another individual's face, in order to prepare for a new round of affiliative face-to-face interactions.
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Affiliation(s)
- Silvia Spadacenta
- Cognitive Neurology Laboratory, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Peter W Dicke
- Cognitive Neurology Laboratory, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Peter Thier
- Cognitive Neurology Laboratory, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
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3
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Diniz NLF, Parlato-Oliveira E, Pimenta PGA, de Araújo LA, Valadares ER. Autism and Down syndrome: early identification and diagnosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:620-630. [PMID: 35946706 PMCID: PMC9387185 DOI: 10.1590/0004-282x-anp-2021-0156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 06/15/2023]
Abstract
The diagnosis of autism spectrum disorder (ASD) in Down syndrome (DS) is underestimated because it is necessary to understand which aspects of the behavioral phenotype are related to DS and which are related to ASD. Objective: To conduct a systematic review of the literature on early identification and diagnosis of ASD in patients with DS. Data source: The VHL, MEDLINE, Cochrane, CINAHL, Scopus, Web of Science and Embase databases were searched and data were evaluated using PRISMA. Data synthesis: Out of 1,729 articles evaluated, 15 were selected. Although well studied, identification of ASD in DS can be difficult because of the need to understand which aspects of the behavioral phenotype are related to Down syndrome and which to autism. In this review, the prevalence of ASD was found to range from 12% to 41%. Early identification of autism risk in individuals with Down syndrome is still poorly studied, even though there are screening instruments for infants. Several instruments for diagnosing autism in individuals with Down syndrome were found, but a developmental approach is fundamental for making a clear diagnosis. Conclusions: Screening procedures are important for detecting early signs of autism risk in the first year of life. Careful evaluation methods are needed to establish the diagnosis, which include choosing appropriate tools for evaluation of development and cognition, and analysis of qualitative aspects of social interaction, among others. It has been indicated in the literature that early detection and timely accurate diagnosis, in association with an intervention, may benefit development, quality of life and social inclusion.
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Affiliation(s)
- Natália Lisce Fioravante Diniz
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa Saúde da Criança e do Adolescente, Belo Horizonte MG, Brasil
| | - Erika Parlato-Oliveira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa Saúde da Criança e do Adolescente, Belo Horizonte MG, Brasil
- CRPMS, UFR Études Psychanalytiques, Université Paris Diderot, Paris, France
- CRPMS, Université de Paris, Paris, France
| | | | - Liubiana Arantes de Araújo
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa Saúde da Criança e do Adolescente, Belo Horizonte MG, Brasil
| | - Eugênia Ribeiro Valadares
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa Saúde da Criança e do Adolescente, Belo Horizonte MG, Brasil
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4
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Attar N, Al-Hroub A, El Zein F. Effects of Three Music Therapy Interventions on the Verbal Expressions of Children With Autism Spectrum Disorder: A Combined Single-Subject Design. Front Psychol 2022; 13:819473. [PMID: 35310290 PMCID: PMC8931400 DOI: 10.3389/fpsyg.2022.819473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
The specific aims of this research study were to (a) examine the differential effect of three different music interventions, namely the interactive music playing therapy ("music and singing"), interaction music singing therapy ("singing"), and receptive music therapy ("listening") studying the varying latency periods in the response time it took 3-year-old children diagnosed with autism spectrum disorder (ASD) to elicit the target word vocally; and (b) assess the index of happiness of children with ASD after the implementation of the three music interventions, which can, in turn, be used to influence their overall quality of life through this specific intervention. This study used a combined single-subject research design consisting of delayed multiple baseline across the participants and a multielement design to compare the effects of each music intervention technique targeting the child's verbal response during playback of a practiced song. Findings demonstrated "singing" to be associated with the lowest latency compared to the other two interventions ("listening" and "singing and music") across participants. Additionally, happiness levels varied from neutral to happy, signifying an overall positive experience during participation in the music applied behavior analysis (ABA) intervention.
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Affiliation(s)
- Nayla Attar
- Department of Education, American University of Beirut, Beirut, Lebanon
| | - Anies Al-Hroub
- Department of Education, American University of Beirut, Beirut, Lebanon
| | - Farah El Zein
- Emirates College for Advanced Education, Abu Dhabi, United Arab Emirates
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5
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Davis PH, Elsayed H, Crais ER, Watson LR, Grzadzinski R. Caregiver responsiveness as a mechanism to improve social communication in toddlers: Secondary analysis of a randomized controlled trial. Autism Res 2022; 15:366-378. [PMID: 34799999 PMCID: PMC8821206 DOI: 10.1002/aur.2640] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 10/19/2021] [Accepted: 10/23/2021] [Indexed: 02/03/2023]
Abstract
Early intensive behavioral interventions (EIBI) for children at elevated likelihood for a later diagnosis of autism spectrum disorder (EL-ASD), are often delivered through parent-mediated models. An area of current exploration is whether changes in caregiver behaviors are a mechanism through which to improve and track child behaviors in these interventions. Toddlers and their caregivers participated in an intervention trial (randomized controlled trial) and were randomized to either a parent-mediated intervention (adapted responsive teaching; ART) or a control condition (referral to early intervention and monitoring; REIM). Changes in toddler social communication (SC) behaviors and characteristics of caregiver responsiveness (CR) were quantified over 8 months. Analyses were conducted to assess whether changes in CR mediated the relation between group (ART vs. REIM) and changes in child SC. Results of the current study indicated that caregivers who participated in a parent-mediated intervention improved in three domains of CR (contingent verbal sensitivity, responsivity, affect). CR was also found to be a mechanism through which children's SC skills improved. This work provides evidence that qualities of CR serve as mechanisms through which to improve and monitor child behaviors over the course of EIBIs. These results may lead to novel intervention targets, methods for tracking change, and tailored treatment planning for toddlers with EL-ASD. The data used in this study comes from a clinical trial that was prospectively registered with the Registry of Efficacy and Effectiveness Studies (Registry ID: 316.1v1). LAY SUMMARY: Interventions for toddlers with high likelihood for a later diagnosis of autism often include the caregiver as an active participant in the intervention. In this study, we aimed to understand qualities of caregiver responsiveness (CR) that facilitate improvements in child behaviors during intervention. Results show that increasing verbal CR and affect are ways to improve child social skills over the course of intervention.
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Affiliation(s)
- Paige Huguely Davis
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, NC
| | - Heba Elsayed
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, NC,Phoniatrics unit, ENT Department, Faculty of Medicine, Alexandria University, Egypt
| | - Elizabeth R. Crais
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, NC,University of North Carolina, Division of Speech and Hearing Sciences
| | - Linda R. Watson
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, NC,University of North Carolina, Division of Speech and Hearing Sciences
| | - Rebecca Grzadzinski
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, NC,University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC
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Talbott MR, Dufek S, Young G, Rogers SJ. Leveraging telehealth to evaluate infants with prodromal autism spectrum disorder characteristics using the telehealth evaluation of development for infants. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1242-1254. [PMID: 34549613 DOI: 10.1177/13623613211045596] [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: 11/16/2022]
Abstract
LAY ABSTRACT Many families seeking early evaluations for autism spectrum disorder face long waitlists, must often travel to centers with appropriate expertise, and are frequently told by providers to "wait and see." This results in significant stress for families and delayed supports to infants and their caregivers who could benefit. This study evaluated whether telehealth could be used to identify and evaluate infants with early autism spectrum disorder characteristics in the first year of life. In this study, we evaluated 41 infants via telehealth using a standard set of probes and scored behavior related to social communication, play, imitation, and other developmental domains. We found the majority of infants demonstrated elevated likelihood of autism spectrum disorder on both parent-reported questionnaires and examiner-rated behavior. Caregiver ratings of the overall utility of the protocol used in this study were high. Overall, this study demonstrates the feasibility for telehealth-based approaches to evaluate infants' with elevated likelihood of autism spectrum disorder in the first year of life, which could help to improve families' access to care and to expand our capacity to conduct studies evaluating possible intervention supports.
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Wolff JJ, Piven J. Predicting Autism in Infancy. J Am Acad Child Adolesc Psychiatry 2021; 60:958-967. [PMID: 33161062 PMCID: PMC8158398 DOI: 10.1016/j.jaac.2020.07.910] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/09/2020] [Accepted: 10/28/2020] [Indexed: 12/17/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication and interaction deficits and restricted, repetitive patterns of interests and behavior that are evident in early childhood. Its prevalence has grown substantially over the past several decades, with current estimates ranging from 1.7% to 2.5% in the United States.1,2 This represents more than 1.5 million children with ASD, the vast majority of whom receive or will receive specialized services.2 Each year, approximately 100,000 (and growing) individuals with ASD reach adulthood, and many face myriad challenges related to employment, housing, mental health, and overburdened or insufficient support services.3-5 A host of significant costs can be associated with ASD, from direct costs related to the provision of special education programs, housing, and medical care to indirect costs, such as loss of productivity affecting both individuals with ASD and their families.6 Currently, overall lifetime cost of care per person with ASD can exceed $3 million, totaling more than $265 billion annually in the United States and rising to an estimated $1 trillion by 2025.7,8.
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Affiliation(s)
- Jason J. Wolff
- Department of Educational Psychology, University of Minnesota
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
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8
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Maylott SE, Sansone JR, Jakobsen KV, Simpson EA. Superior Detection of Faces in Male Infants at 2 Months. Child Dev 2021; 92:e621-e634. [PMID: 33492747 DOI: 10.1111/cdev.13543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Females generally attend more to social information than males; however, little is known about the early development of these sex differences. With eye tracking, 2-month olds' (N = 101; 44 females) social orienting to faces was measured within four-item image arrays. Infants were more likely to detect human faces compared to objects, suggesting a functional face detection system. Unexpectedly, males looked longer at human faces than females, and only males looked faster and longer at human faces compared to objects. Females, in contrast, looked less at human faces relative to animal faces and objects, appearing socially disinterested. Notably, this is the first report of a male face detection advantage at any age. These findings suggest a unique stage in early infant social development.
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9
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Talbott MR, Miller MR. Future Directions for Infant Identification and Intervention for Autism Spectrum Disorder from a Transdiagnostic Perspective. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:688-700. [PMID: 32701034 PMCID: PMC7541743 DOI: 10.1080/15374416.2020.1790382] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
By the time they are typically detected, neurodevelopmental disorders like autism spectrum disorder (ASD) are already challenging to treat. Preventive and early intervention strategies in infancy are critical for improving outcomes over the lifespan with significant cost savings. However, the impact of prevention and early intervention efforts is dependent upon our ability to identify infants most appropriate for such interventions. Because there may be significant overlap between prodromal symptoms across neurodevelopmental disorders and child psychopathology more broadly which may wax and wane across development, we contend that the impact of prevention and early intervention efforts will be heightened by identifying early indicators that may overlap across ASD and other commonly co-occurring disorders. This paper summarizes the existing literature on infant symptoms and identification of ASD to demonstrate the ways in which a transdiagnostic perspective could expand the impact of early identification and intervention research and clinical efforts, and to outline suggestions for future empirical research programs addressing current gaps in the identification-to-treatment pipeline. We propose four recommendations for future research that are both grounded in developmental and clinical science and that are scalable for early intervention systems: (1) development of fine-grained, norm-referenced measures of ASD-relevant transdiagnostic behavioral domains; (2) identification of shared and distinct mechanisms influencing the transition from risk to disorder; (3) determination of key cross-cutting treatment strategies (both novel and extracted from existing approaches) effective in targeting specific domains across disorders; and (4) integration of identified measures and treatments into existing service systems.
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Affiliation(s)
- Meagan R Talbott
- MIND Institute and Department of Psychiatry & Behavioral Sciences, University of California
| | - Meghan R Miller
- MIND Institute and Department of Psychiatry & Behavioral Sciences, University of California
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10
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Caregiver-Implemented Intervention for Young Children with Autism Spectrum Disorder: A Systematic Review of Coaching Components. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00186-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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11
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Adaptive Behavior Acquisition of a Robot Based on Affective Feedback and Improvised Teleoperation. IEEE Trans Cogn Dev Syst 2019. [DOI: 10.1109/tcds.2018.2846778] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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12
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Zhang D, Roche L, Bartl-Pokorny KD, Krieber M, McLay L, Bölte S, Poustka L, Sigafoos J, Gugatschka M, Einspieler C, Marschik PB. Response to name and its value for the early detection of developmental disorders: Insights from autism spectrum disorder, Rett syndrome, and fragile X syndrome. A perspectives paper. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 82:95-108. [PMID: 29655507 PMCID: PMC6093279 DOI: 10.1016/j.ridd.2018.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/02/2018] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Responding to one's own name (RtN) has been reported as atypical in children with developmental disorders, yet comparative studies on RtN across syndromes are rare. AIMS We aim to (a) overview the literature on RtN in different developmental disorders during the first 24 months of life, and (b) report comparative data on RtN across syndromes. METHODS AND PROCEDURES In Part 1, a literature search, focusing on RtN in children during the first 24 months of life with developmental disorders, identified 23 relevant studies. In Part 2, RtN was assessed utilizing retrospective video analysis for infants later diagnosed with ASD, RTT, or FXS, and typically developing peers. OUTCOMES AND RESULTS Given a variety of methodologies and instruments applied to assess RtN, 21/23 studies identified RtN as atypical in infants with a developmental disorder. We observed four different developmental trajectories of RtN in ASD, RTT, PSV, and FXS from 9 to 24 months of age. Between-group differences became more distinctive with age. CONCLUSIONS AND IMPLICATIONS RtN may be a potential parameter of interest in a comprehensive early detection model characterising age-specific neurofunctional biomarkers associated with specific disorders, and contribute to early identification.
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Affiliation(s)
- Dajie Zhang
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria; Department of Child and Adolescent Psychiatry and Psychotherapy, iDN - Interdisciplinary Developmental Neuroscience, University Medical Centre Göttingen, Göttingen, Germany.
| | - Laura Roche
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria; School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Katrin D Bartl-Pokorny
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Magdalena Krieber
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Laurie McLay
- School of Health Sciences, College of Education, University of Canterbury, Christchurch, New Zealand
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, iDN - Interdisciplinary Developmental Neuroscience, University Medical Centre Göttingen, Göttingen, Germany
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Markus Gugatschka
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Christa Einspieler
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Peter B Marschik
- Research Unit iDN - interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Graz, Austria; Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Child and Adolescent Psychiatry and Psychotherapy, iDN - Interdisciplinary Developmental Neuroscience, University Medical Centre Göttingen, Göttingen, Germany
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13
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Vivanti G, Hamner T, Lee NR. Neurodevelopmental Disorders Affecting Sociability: Recent Research Advances and Future Directions in Autism Spectrum Disorder and Williams Syndrome. Curr Neurol Neurosci Rep 2018; 18:94. [DOI: 10.1007/s11910-018-0902-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Vivanti G, Hamner T, Lee NR. Neurodevelopmental Disorders Affecting Sociability: Recent Research Advances and Future Directions in Autism Spectrum Disorder and Williams Syndrome. Curr Neurol Neurosci Rep 2018. [PMID: 30328520 DOI: 10.1007/s11910–018–0902-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW In this review, we summarize current knowledge and hypotheses on the nature of social abnormalities in autism spectrum disorder (ASD) and Williams syndrome (WS). RECENT FINDINGS Social phenotypes in ASD and WS appear to reflect analogous disruptions in social cognition, and distinct patterns of social motivation, which appears to be reduced in ASD and enhanced in WS. These abnormalities likely originate from heterogeneous vulnerabilities that disrupt the interplay between domain-general and social domain-specific cognitive and motivational processes during early development. Causal pathways remain unclear. Advances and research gaps in our understanding of the social phenotypes in ASD and WS highlight the importance of (1) parsing the construct of sociability, (2) adopting a developmental perspective, (3) including samples that are representative of the spectrum of severity within ASD and WS in neuroscientific research, and (4) adopting transdiagnostic treatment approaches to target shared areas of impairment across diagnostic boundaries.
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Affiliation(s)
- Giacomo Vivanti
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104-3734, USA. .,Department of Psychology, Drexel University, Philadelphia, PA, 19104-3734, USA.
| | - Taralee Hamner
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104-3734, USA.,Department of Psychology, Drexel University, Philadelphia, PA, 19104-3734, USA
| | - Nancy Raitano Lee
- Department of Psychology, Drexel University, Philadelphia, PA, 19104-3734, USA
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Hachisu T, Pan Y, Matsuda S, Bourreau B, Suzuki K. FaceLooks: A Smart Headband for Signaling Face-to-Face Behavior. SENSORS 2018; 18:s18072066. [PMID: 29958435 PMCID: PMC6068478 DOI: 10.3390/s18072066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 11/16/2022]
Abstract
Eye-to-eye contact and facial expressions are key communicators, yet there has been little done to evaluate the basic properties of face-to-face; mutual head orientation behaviors. This may be because there is no practical device available to measure the behavior. This paper presents a novel headband-type wearable device called FaceLooks, used for measuring the time of the face-to-face state with identity of the partner, using an infrared emitter and receiver. It can also be used for behavioral healthcare applications, such as for children with developmental disorders who exhibit difficulties with the behavior, by providing awareness through the visual feedback from the partner’s device. Two laboratory experiments showed the device’s detection range and response time, tested with a pair of dummy heads. Another laboratory experiment was done with human participants with gaze trackers and showed the device’s substantial agreement with a human observer. We then conducted two field studies involving children with intellectual disabilities and/or autism spectrum disorders. The first study showed that the devices could be used in the school setting, observing the children did not remove the devices. The second study showed that the durations of children’s face-to-face behavior could be increased under a visual feedback condition. The device shows its potential to be used in therapy and experimental fields because of its wearability and its ability to quantify and shape face-to-face behavior.
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Affiliation(s)
- Taku Hachisu
- Faculty of Engineering, Information and Systems, University of Tsukuba, Tsukuba 3058573, Japan.
| | - Yadong Pan
- Empowerment Informatics Program, University of Tsukuba, Tsukuba 3058573, Japan.
| | - Soichiro Matsuda
- Faculty of Human Sciences, University of Tsukuba, Tsukuba 3058573, Japan.
| | - Baptiste Bourreau
- Faculty of Engineering, Information and Systems, University of Tsukuba, Tsukuba 3058573, Japan.
| | - Kenji Suzuki
- Faculty of Engineering, Information and Systems, University of Tsukuba, Tsukuba 3058573, Japan.
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16
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Howsmon DP, Vargason T, Rubin RA, Delhey L, Tippett M, Rose S, Bennuri SC, Slattery JC, Melnyk S, James SJ, Frye RE, Hahn J. Multivariate techniques enable a biochemical classification of children with autism spectrum disorder versus typically-developing peers: A comparison and validation study. Bioeng Transl Med 2018; 3:156-165. [PMID: 30065970 PMCID: PMC6063877 DOI: 10.1002/btm2.10095] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/10/2018] [Accepted: 05/10/2018] [Indexed: 01/05/2023] Open
Abstract
Autism spectrum disorder (ASD) is a developmental disorder which is currently only diagnosed through behavioral testing. Impaired folate‐dependent one carbon metabolism (FOCM) and transsulfuration (TS) pathways have been implicated in ASD, and recently a study involving multivariate analysis based upon Fisher Discriminant Analysis returned very promising results for predicting an ASD diagnosis. This article takes another step toward the goal of developing a biochemical diagnostic for ASD by comparing five classification algorithms on existing data of FOCM/TS metabolites, and also validating the classification results with new data from an ASD cohort. The comparison results indicate a high sensitivity and specificity for the original data set and up to a 88% correct classification of the ASD cohort at an expected 5% misclassification rate for typically‐developing controls. These results form the foundation for the development of a biochemical test for ASD which promises to aid diagnosis of ASD and provide biochemical understanding of the disease, applicable to at least a subset of the ASD population.
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Affiliation(s)
- Daniel P Howsmon
- Dept. of Chemical & Biological Engineering Rensselaer Polytechnic Institute Troy NY 12180.,Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute Troy NY 12180
| | - Troy Vargason
- Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute Troy NY 12180.,Dept. of Biomedical Engineering Rensselaer Polytechnic Institute Troy NY 12180
| | | | - Leanna Delhey
- Arkansas Children's Research Institute Little Rock AR 72202.,Dept. of Pediatrics University of Arkansas for Medical Sciences Little Rock AR 72205
| | - Marie Tippett
- Arkansas Children's Research Institute Little Rock AR 72202.,Dept. of Pediatrics University of Arkansas for Medical Sciences Little Rock AR 72205
| | - Shannon Rose
- Arkansas Children's Research Institute Little Rock AR 72202.,Dept. of Pediatrics University of Arkansas for Medical Sciences Little Rock AR 72205
| | - Sirish C Bennuri
- Arkansas Children's Research Institute Little Rock AR 72202.,Dept. of Pediatrics University of Arkansas for Medical Sciences Little Rock AR 72205
| | - John C Slattery
- Dept. of Pediatrics University of Arkansas for Medical Sciences Little Rock AR 72205
| | - Stepan Melnyk
- Dept. of Pediatrics University of Arkansas for Medical Sciences Little Rock AR 72205
| | - S Jill James
- Dept. of Pediatrics University of Arkansas for Medical Sciences Little Rock AR 72205
| | - Richard E Frye
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ 85013 and University of Arizona College of Medicine Phoenix AZ 85004
| | - Juergen Hahn
- Dept. of Chemical & Biological Engineering Rensselaer Polytechnic Institute Troy NY 12180.,Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute Troy NY 12180.,Dept. of Biomedical Engineering Rensselaer Polytechnic Institute Troy NY 12180
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17
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Parent-Mediated Intervention for One-Year-Olds Screened as At-Risk for Autism Spectrum Disorder: A Randomized Controlled Trial. J Autism Dev Disord 2018; 47:3520-3540. [PMID: 28861651 DOI: 10.1007/s10803-017-3268-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Theoretically, interventions initiated with at-risk infants prior to the point in time a definitive autism spectrum disorder (ASD) diagnosis can be made will improve outcomes. Pursuing this idea, we tested the efficacy of a parent-mediated early intervention called Adapted Responsive Teaching (ART) via a randomized controlled trial with 87 one-year-olds identified by community screening with the First Year Inventory as at-risk of later ASD diagnoses. We found minimal evidence for main effects of ART on child outcomes. However, ART group parents showed significantly greater increases in responsiveness to their infants than control group parents. Further, significant indirect (mediation) effects of assignment group on multiple child outcomes through changes in parent responsiveness supported our theory of change.
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18
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Green J, Garg S. Annual Research Review: The state of autism intervention science: progress, target psychological and biological mechanisms and future prospects. J Child Psychol Psychiatry 2018; 59:424-443. [PMID: 29574740 DOI: 10.1111/jcpp.12892] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND There has been recent systematic review of key evidence in psychosocial intervention in autism but little review of biological treatments. METHODS We analyse the current literature from the perspective of intervention and mechanism targets across social and biological development. RESULTS The overall quality of trials evidence in autism intervention remains relatively low, despite some recent progress. Many treatments in common use have little or no evidence base. This is very concerning in such an important disorder. A variety of psychosocial interventions can show effect to improve some short-term effects on children's immediate dyadic social interactions, for instance with caregivers. But showing true effectiveness in this developmental disorder requires generalisation of such effects into wider social contexts, on autism symptoms and in long-term progress in development. Only a few interventions so far have begun to show this. A number of early phase interventions on biological targets have shown real promise, but none has yet progressed to larger scale effectiveness trials on behavioural or symptom outcomes. CONCLUSIONS There has been enough progress in psychosocial intervention research now to be able to begin to identify some evidence-based practice in autism treatment. To consolidate and improve outcomes, the next phase of intervention research needs improved trial design, and an iterative approach building on success. It may also include the testing of potential synergies between promising biological and psychosocial interventions.
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Affiliation(s)
- Jonathan Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Shruti Garg
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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19
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Larsen K, Aasland A, Diseth TH. Identification of Symptoms of Autism Spectrum Disorders in the Second Year of Life at Day-Care Centres by Day-Care Staff: Step One in the Development of a Short Observation List. J Autism Dev Disord 2018; 48:2267-2277. [PMID: 29423606 DOI: 10.1007/s10803-018-3489-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Early symptoms of ASD develop through the second year of life, making a stable ASD diagnosis possible at 24 months of age. However, in general, children with ASD have their diagnosis at an older age. This retrospective study, including 30 children with ASD and 30 control children aged 3-6 years, explored the possibility of developing a short observation list to be used in day care settings for children 12-24 months of age. From 73 symptoms selected from published screeners and observation tools, we were able to construct a list of six symptoms that retrospectively differentiated children with ASD from typically developing children at 12-24 months of age when recalled by day-care personnel.
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Affiliation(s)
- Kenneth Larsen
- Division of Paediatric and Adolescent Medicine, Regional Resource Centre for Autism, ADHD, Tourette's Syndrome and Narcolepsy, Oslo University Hospital, Oslo, Norway.
| | - Astrid Aasland
- Section of Psychosomatics and CL-Child Psychiatry, Division of Paediatric and Adolescent Medicine, Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Trond H Diseth
- Section of Psychosomatics and CL-Child Psychiatry, Division of Paediatric and Adolescent Medicine, Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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20
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Abstract
With advances in the field's ability to identify autism spectrum disorders (ASD) at younger ages, the need for information about the evidence-base for early intervention continues to rise. This review of the ASD early intervention (EI) literature focuses on efficacy studies published within the past 15 years. The neurodevelopmental context for early intervention, timing of initiating intervention, primary intervention approaches, and predictors of treatment outcomes are discussed. The evidence indicates that young children with ASD benefit from EI, and their parents learn to implement child-responsive engagement strategies when a parent-coaching intervention is provided. Evidence supports combining parent-mediated and direct clinician-implemented intervention to maximize child developmental gains. Clinical practice recommendations are presented, based on the literature reviewed.
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Affiliation(s)
- Rebecca J. Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
- Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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21
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22
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Strength-Based Approaches to Working with Families of Children with ASD. HANDBOOK OF PARENT-IMPLEMENTED INTERVENTIONS FOR VERY YOUNG CHILDREN WITH AUTISM 2018. [DOI: 10.1007/978-3-319-90994-3_10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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23
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Green J, Pickles A, Pasco G, Bedford R, Wan MW, Elsabbagh M, Slonims V, Gliga T, Jones E, Cheung C, Charman T, Johnson M. Randomised trial of a parent-mediated intervention for infants at high risk for autism: longitudinal outcomes to age 3 years. J Child Psychol Psychiatry 2017; 58:1330-1340. [PMID: 28393350 PMCID: PMC5724485 DOI: 10.1111/jcpp.12728] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND There has been increasing interest in the potential for pre-emptive interventions in the prodrome of autism, but little investigation as to their effect. METHODS A two-site, two-arm assessor-blinded randomised controlled trial (RCT) of a 12-session parent-mediated social communication intervention delivered between 9 and 14 months of age (Intervention in the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting), against no intervention. Fifty-four infants (28 intervention, 26 nonintervention) at familial risk of autism but not otherwise selected for developmental atypicality were assessed at 9-month baseline, 15-month treatment endpoint, and 27- and 39-month follow-up. PRIMARY OUTCOME severity of autism prodromal symptoms, blind-rated on Autism Observation Schedule for Infants or Autism Diagnostic Observation Schedule 2nd Edition across the four assessment points. SECONDARY OUTCOMES blind-rated parent-child interaction and child language; nonblind parent-rated communication and socialisation. Prespecified intention-to-treat analysis combined estimates from repeated measures within correlated regressions to estimate the overall effect of the infancy intervention over time. RESULTS Effect estimates in favour of intervention on autism prodromal symptoms, maximal at 27 months, had confidence intervals (CIs) at each separate time point including the null, but showed a significant overall effect over the course of the intervention and follow-up period (effect size [ES] = 0.32; 95% CI 0.04, 0.60; p = .026). Effects on proximal intervention targets of parent nondirectiveness/synchrony (ES = 0.33; CI 0.04, 0.63; p = .013) and child attentiveness/communication initiation (ES = 0.36; 95% CI 0.04, 0.68; p = .015) showed similar results. There was no effect on categorical diagnostic outcome or formal language measures. CONCLUSIONS Follow-up to 3 years of the first RCT of a very early social communication intervention for infants at familial risk of developing autism has shown a treatment effect, extending 24 months after intervention end, to reduce the overall severity of autism prodromal symptoms and enhance parent-child dyadic social communication over this period. We highlight the value of extended follow-up and repeat assessment for early intervention trials.
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Affiliation(s)
- Jonathan Green
- Social Development Research GroupSchool of Biological SciencesUniversity of ManchesterManchesterUK,Royal Manchester Children's HospitalManchesterUK
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK,National Institute for Health Research Medical Health Biomedical Research CentreSouth London and Maudsley NHS Foundation TrustLondonUK
| | - Greg Pasco
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK,Centre for Brain and Cognitive DevelopmentBirkbeck CollegeLondonUK
| | - Rachael Bedford
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Ming Wai Wan
- School of Health SciencesUniversity of ManchesterManchesterUK
| | - Mayada Elsabbagh
- Centre for Brain and Cognitive DevelopmentBirkbeck CollegeLondonUK,Department of PsychiatryMcGill UniversityWest MontréalQCCanada
| | - Vicky Slonims
- Evelina London Children's Hospital and King's College London Neurosciences CentreLondonUK
| | - Teea Gliga
- Centre for Brain and Cognitive DevelopmentBirkbeck CollegeLondonUK
| | - Emily Jones
- Centre for Brain and Cognitive DevelopmentBirkbeck CollegeLondonUK
| | - Celeste Cheung
- Centre for Brain and Cognitive DevelopmentBirkbeck CollegeLondonUK
| | - Tony Charman
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Mark Johnson
- Centre for Brain and Cognitive DevelopmentBirkbeck CollegeLondonUK
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24
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Fossum KL, Williams L, Garon N, Bryson SE, Smith IM. Pivotal response treatment for preschoolers with autism spectrum disorder: Defining a predictor profile. Autism Res 2017; 11:153-165. [PMID: 28861936 DOI: 10.1002/aur.1859] [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] [Received: 05/25/2017] [Revised: 07/24/2017] [Accepted: 08/14/2017] [Indexed: 12/22/2022]
Abstract
Behavioral characteristics of children with autism spectrum disorder (ASD) who respond positively to Pivotal Response Treatment (PRT) have been described previously, based on single-subject design research. The present study examined several such characteristics, as well as positive affect, as predictors of expressive language (EL) gains in a representative sample of preschoolers with ASD (n = 57) enrolled in a PRT-based community early intervention program. Children's cognitive ability, positive affect, and levels of appropriate toy contact measured at the start of intervention each contributed significantly to the prediction of EL outcomes. Together these variables accounted for 40% of the total outcome variance. In addition, a profile of increased EL ability, positive affect and appropriate toy contact, and decreased social avoidance and stereotyped and repetitive vocalizations was associated with greater gains during intervention. Results are discussed in relation to their implications for understanding both the variable treatment response documented in children with ASD and how to tailor treatment to optimize individual benefit. Autism Res 2018, 11: 153-165. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY The study examined behavior of 57 preschoolers who made the greatest and least gains from 1 year of a community Pivotal Response Treatment program. Using pre-treatment videos, we saw that children who made the most progress showed more language, positive affect, and appropriate interactions with toys, also less avoidance of people and fewer repetitive vocalizations. Behavior profiles can be used to match treatment to individual children's needs.
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Affiliation(s)
- Kristin-Lee Fossum
- Department of Psychology & Neuroscience, Dalhousie University, PO Box 15000 Halifax, NS, B3H 4R2, Canada
| | - Loriann Williams
- Department of Psychology & Neuroscience, Dalhousie University, PO Box 15000 Halifax, NS, B3H 4R2, Canada
| | - Nancy Garon
- Department of Psychology, Mount Allison University, 49A York Street, Sackville, NB, E4L 1C7, Canada
| | - Susan E Bryson
- Department of Pediatrics, Dalhousie University, Autism Research Centre, IWK Health Centre, PO Box 9700, Halifax, NS, B3J 6R8, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Autism Research Centre, IWK Health Centre, PO Box 9700, Halifax, NS, B3J 6R8, Canada
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25
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Abstract
Pivotal response treatment (PRT) is an evidence-based behavioral intervention based on applied behavior analysis principles aimed to improve social communication skills in individuals with autism spectrum disorder (ASD). PRT adopts a more naturalistic approach and focuses on using a number of strategies to help increase children's motivation during intervention. Since its conceptualization, PRT has received much empirical support for eliciting therapeutic gains in greater use of functional social communication skills in individuals with ASD. Building upon the empirical evidence supporting PRT, recent advancements have increasingly turned to using interdisciplinary research integrating neuroimaging techniques and behavioral measures to help identify objective biomarkers of treatment, which have two primary purposes. First, neuroimaging results can help characterize how PRT may elicit change, and facilitate partitioning of the heterogeneous profiles of neural mechanisms underlying similar profile of behavioral changes observed over PRT. Second, neuroimaging provides an objective means to both map and track how biomarkers may serve as reliable and sensitive predictors of responder profiles to PRT, assisting clinicians to identify who will most likely benefit from PRT. Together, a better understanding of both mechanisms of change and predictors of responder profile will help PRT to serve as a more precise and targeted intervention for individuals with ASD, thus moving towards the goal of precision medicine and improving quality of care. This review focuses on the recent emerging neuroimaging evidences supporting PRT, offering current perspectives on the importance of interdisciplinary research to help clinicians better understand how PRT works and predict who will respond to PRT.
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Affiliation(s)
- Jiedi Lei
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Pamela Ventola
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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26
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Whitehouse AJO. Elizabeth Usher Memorial Lecture: Rethinking the clinical pathway for autism spectrum disorder and challenging the status quo. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:208-217. [PMID: 28084105 DOI: 10.1080/17549507.2016.1276963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
Autism spectrum disorder (ASD) is typically diagnosed between 2 and 5 years of age, which is currently thought to be the earliest that the behavioural symptoms are able to be identified without ambiguity. A significant problem with this relatively "late" age of diagnosis is that by the time a child has been identified and diagnosed with ASD, many of the best opportunities for therapies to capitalise upon brain plasticity very early in development are not realised. This paper provides an overview of the benefits and drawbacks of the current clinical pathway that places primacy on a diagnostic assessment for triggering the commencement of therapy. The paper then presents an alternative clinical pathway - the identification and provision of therapy to infants at risk of ASD - and provides a critical review of current evidence supporting this model. The aim of the paper is to outline a vision for the future of early identification and intervention of individuals with ASD, and the research goals that need to be addressed to achieve this vision.
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Affiliation(s)
- Andrew J O Whitehouse
- a Telethon Kids Institute, The University of Western Australia , Subiaco , Australia
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27
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Bradshaw J, Koegel LK, Koegel RL. Improving Functional Language and Social Motivation with a Parent-Mediated Intervention for Toddlers with Autism Spectrum Disorder. J Autism Dev Disord 2017; 47:2443-2458. [DOI: 10.1007/s10803-017-3155-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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28
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Bornstein MH, Costlow K, Truzzi A, Esposito G. Categorizing the cries of infants with ASD versus typically developing infants: A study of adult accuracy and reaction time. RESEARCH IN AUTISM SPECTRUM DISORDERS 2016; 31:66-72. [PMID: 28138338 PMCID: PMC5271596 DOI: 10.1016/j.rasd.2016.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The cries of children with Autism Spectrum Disorder (ASD) contain atypical acoustic features. The cries of typically developing infants elicit automatic adult responses, but little is known about how the atypical cries of children with ASD affect the speed with which adults process them. METHOD We used a reaction time (RT) categorical task to analyze adults' categorization of typically developing cries, atypical (ASD) cries, mammalian animal cries, and environmental noise control sounds. 40 nonparent women (M age = 27 years) were instructed to categorize acoustic stimuli as human infant cries or non-human sounds as quickly as possible. RESULTS The RTs for correctly categorizing the cries of children with ASD (M = 831ms, SEM = 27) were slower than RTs for typically developing child cries (M = 680ms, SEM = 6) as well as mammalian animal cries (801ms, SEM = 11) and environmental noise control sounds (M = 692ms, SEM = 10). CONCLUSIONS This difference may reflect difficulties in adults' perceiving and processing atypical cries of children with ASD, and the findings may have implications for the parent-child relationship and for the quality of care children with ASD receive.
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Affiliation(s)
- M H Bornstein
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, USA
| | - K Costlow
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, USA
| | - A Truzzi
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, USA
| | - G Esposito
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, USA
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29
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30
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Brian JA, Smith IM, Zwaigenbaum L, Roberts W, Bryson SE. The Social ABCs caregiver-mediated intervention for toddlers with autism spectrum disorder: Feasibility, acceptability, and evidence of promise from a multisite study. Autism Res 2015; 9:899-912. [PMID: 26688077 PMCID: PMC5064621 DOI: 10.1002/aur.1582] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/29/2015] [Indexed: 11/08/2022]
Abstract
The Social ABCs is a parent-mediated intervention for toddlers with suspected or confirmed autism spectrum disorder (ASD). We undertook a multi-site pilot study to evaluate feasibility and acceptability, and to identify trends in child and parent behavior to inform future research using a larger sample and a rigorous research design. The program involved 12 weeks of parent coaching, followed by 12 weeks' implementation, and 3-month follow-up assessment for 20 parent-toddler dyads (age range: 12-32 months). Parents successfully learned the techniques and rated the intervention as highly acceptable. Paired samples t-tests revealed significant gains in children's functional communication (responsivity, initiations), and language gains (age-equivalents on standardized measures) commensurate with typical developmental rates. Significant increases in shared smiling and social orienting also emerged, but were attenuated at follow-up. Parents' fidelity was positively associated with child responsivity. Training parents as mediators is a feasible and highly acceptable approach that provides a potentially cost-effective opportunity for intensive intervention at a very young age at the first signs of ASD risk. Child and parent gains in several key variables demonstrate the promise of this intervention. Autism Res 2016, 9: 899-912. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.
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Affiliation(s)
- Jessica A Brian
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Isabel M Smith
- Departments of Pediatrics and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Wendy Roberts
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.,Integrated Services for Autism and Neurodevelopmental Disorders, Toronto, Ontario, Canada
| | - Susan E Bryson
- Departments of Pediatrics and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
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31
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Wade M, Prime H, Madigan S. Using Sibling Designs to Understand Neurodevelopmental Disorders: From Genes and Environments to Prevention Programming. BIOMED RESEARCH INTERNATIONAL 2015; 2015:672784. [PMID: 26258141 PMCID: PMC4518166 DOI: 10.1155/2015/672784] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/05/2015] [Accepted: 06/28/2015] [Indexed: 01/30/2023]
Abstract
Neurodevelopmental disorders represent a broad class of childhood neurological conditions that have a significant bearing on the wellbeing of children, families, and communities. In this review, we draw on evidence from two common and widely studied neurodevelopmental disorders-autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD)-to demonstrate the utility of genetically informed sibling designs in uncovering the nature and pathogenesis of these conditions. Specifically, we examine how twin, recurrence risk, and infant prospective tracking studies have contributed to our understanding of genetic and environmental liabilities towards neurodevelopmental morbidity through their impact on neurocognitive processes and structural/functional neuroanatomy. It is suggested that the siblings of children with ASD and ADHD are at risk not only of clinically elevated problems in these areas, but also of subthreshold symptoms and/or subtle impairments in various neurocognitive skills and other domains of psychosocial health. Finally, we close with a discussion on the practical relevance of sibling designs and how these might be used in the service of early screening, prevention, and intervention efforts that aim to alleviate the negative downstream consequences associated with disorders of neurodevelopment.
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Affiliation(s)
- Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street W., Toronto, ON, Canada M5S 1V6
| | - Heather Prime
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street W., Toronto, ON, Canada M5S 1V6
| | - Sheri Madigan
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
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32
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Bradshaw J, Steiner AM, Gengoux G, Koegel LK. Feasibility and effectiveness of very early intervention for infants at-risk for autism spectrum disorder: a systematic review. J Autism Dev Disord 2015; 45:778-94. [PMID: 25218848 DOI: 10.1007/s10803-014-2235-2] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Early detection methods for autism spectrum disorder (ASD) in infancy are rapidly advancing, yet the development of interventions for infants under two years with or at-risk for ASD remains limited. In order to guide research and practice, this paper systematically reviewed studies investigating interventions for infants under 24 months with or at-risk for ASD. Nine studies were identified and evaluated for: (a) participants, (b) intervention approach (c) experimental design, and (d) outcomes. Studies that collected parent measures reported positive findings for parent acceptability, satisfaction, and improvement in parent implementation of treatment. Infant gains in social-communicative and developmental skills were observed following intervention in most of the reviewed studies, while comparisons with treatment-as-usual control groups elucidate the need for further research. These studies highlight the feasibility of very early intervention and provide preliminary evidence that intervention for at-risk infants may be beneficial for infants and parents.
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Affiliation(s)
- Jessica Bradshaw
- Counseling, Clinical, and School Psychology Department, Koegel Autism Center, Graduate School of Education, University of California, Santa Barbara, CA, USA,
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33
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Green J, Charman T, Pickles A, Wan MW, Elsabbagh M, Slonims V, Taylor C, McNally J, Booth R, Gliga T, Jones EJH, Harrop C, Bedford R, Johnson MH. Parent-mediated intervention versus no intervention for infants at high risk of autism: a parallel, single-blind, randomised trial. Lancet Psychiatry 2015; 2:133-40. [PMID: 26359749 PMCID: PMC4722333 DOI: 10.1016/s2215-0366(14)00091-1] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 11/18/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Risk markers for later autism identified in the first year of life present plausible intervention targets during early development. We aimed to assess the effect of a parent-mediated intervention for infants at high risk of autism on these markers. METHODS We did a two-site, two-arm assessor-blinded randomised controlled trial of families with an infant at familial high risk of autism aged 7-10 months, testing the adapted Video Interaction to Promote Positive Parenting (iBASIS-VIPP) versus no intervention. Families were randomly assigned to intervention or no intervention groups using a permuted block approach stratified by centre. Assessors, but not families or therapists, were masked to group assignment. The primary outcome was infant attentiveness to parent. Regression analysis was done on an intention-to-treat basis. This trial is registered with ISCRTN Registry, number ISRCTN87373263. FINDINGS We randomly assigned 54 families between April 11, 2011, and Dec 4, 2012 (28 to intervention, 26 to no intervention). Although CIs sometimes include the null, point estimates suggest that the intervention increased the primary outcome of infant attentiveness to parent (effect size 0.29, 95% CI -0.26 to 0.86, thus including possibilities ranging from a small negative treatment effect to a strongly positive treatment effect). For secondary outcomes, the intervention reduced autism-risk behaviours (0.50, CI -0.15 to 1.08), increased parental non-directiveness (0.81, 0.28 to 1.52), improved attention disengagement (0.48, -0.01 to 1.02), and improved parent-rated infant adaptive function (χ(2)[2] 15.39, p=0.0005). There was a possibility of nil or negative effect in language and responsivity to vowel change (P1: ES-0.62, CI -2.42 to 0.31; P2: -0.29, -1.55 to 0.71). INTERPRETATION With the exception of the response to vowel change, our study showed positive estimates across a wide range of behavioural and brain function risk-markers and developmental outcomes that are consistent with a moderate intervention effect to reduce the risk for later autism. However, the estimates have wide CIs that include possible nil or small negative effects. The results are encouraging for development and prevention science, but need larger-scale replication to improve precision. FUNDING Autistica, Waterloo Foundation, Autism Speaks, and the UK Medical Research Council.
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Affiliation(s)
- Jonathan Green
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
| | - Tony Charman
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Department of Psychology, London, UK
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Department of Psychology, London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ming W Wan
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Mayada Elsabbagh
- Centre for Brain and Cognitive Development, Birkbeck College, London, UK; Department of Psychiatry, McGill University, West Montreal, QC, Canada
| | - Vicky Slonims
- Evelina London Children's Hospital and Kings College London Neurosciences Centre, London, UK
| | - Carol Taylor
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Janet McNally
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK; Institute of Psychological Sciences, University of Leeds, Leeds, UK
| | - Rhonda Booth
- Institute of Child Health, University College London, London, UK
| | - Teodora Gliga
- Centre for Brain and Cognitive Development, Birkbeck College, London, UK
| | - Emily J H Jones
- Centre for Brain and Cognitive Development, Birkbeck College, London, UK
| | - Clare Harrop
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK; Kasari Lab, UCLA Center for Autism Research and Treatment, Semel Institute, Los Angeles, CA, USA
| | - Rachael Bedford
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Department of Psychology, London, UK
| | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck College, London, UK
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Larsen K. The Early Diagnosis of Preschool Children with Autism Spectrum Disorder in Norway: a Study of Diagnostic Age and Its Associated Factors. Scand J Child Adolesc Psychiatr Psychol 2015. [DOI: 10.21307/sjcapp-2015-014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Rowberry J, Macari S, Chen G, Campbell D, Leventhal JM, Weitzman C, Chawarska K. Screening for autism spectrum disorders in 12-month-old high-risk siblings by parental report. J Autism Dev Disord 2015; 45:221-9. [PMID: 25149178 PMCID: PMC4289092 DOI: 10.1007/s10803-014-2211-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examines whether parental report of social-communicative and repetitive behaviors at 12 months can be helpful in identifying autism spectrum disorder (ASD) in younger siblings of children with ASD [high-risk (HR)-siblings]. Parents of HR-siblings and infants without a family history of ASD completed the First Year Inventory at 12 months. Developmental outcomes were based on 24- or 36-month assessments. HR-siblings later diagnosed with ASD showed greater impairments in social communication than those with other developmental outcomes based on parental and clinician ratings. Parental report of decline in play and communication and impaired vocal imitation correctly classified a majority of ASD cases with high specificity. These preliminary findings have important implications for the development of early screening instruments for ASD in HR-siblings.
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Affiliation(s)
- Justin Rowberry
- Developmental and Behavioral Pediatrics, Mike O'Callaghan Federal Medical Center, 4700 Las Vegas Boulevard North, Building 1300, Nellis Air Force Base, NV, 89191, USA,
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