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Bowler A, Arichi T, Austerberry C, Fearon P, Ronald A. A Systematic Review and Meta-Analysis of the Associations Between Motor Milestone Timing and Motor Development in Neurodevelopmental Conditions. Neurosci Biobehav Rev 2024:105825. [PMID: 39067834 DOI: 10.1016/j.neubiorev.2024.105825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/16/2024] [Accepted: 07/21/2024] [Indexed: 07/30/2024]
Abstract
Early motor skills may be important early markers of neurodevelopmental conditions or predictors of their later onset. To explore this, we conducted a systematic review and meta-analysis of infant motor skill assessments in those who go on to gain a clinical diagnosis of autism, attention deficit hyperactivity disorder (ADHD), schizophrenia, language conditions, tic disorders, or developmental coordination disorder (DCD). In total, 65 articles met inclusion criteria. Three three-level meta-analyses were run. Meta-analysis of milestone achievement in N=21354 individuals revealed gross motor milestones were significantly delayed compared to controls (g= 0.53, p< 0.001). Subgroup analyses revealed autism (g= 0.63) and DCD (g= 0.53) had the highest magnitude delays. Specific delays were revealed for holding the head up (g= 0.21), sitting (g= 0.28), standing (g= 0.35), crawling (g=0.19), and walking (g= 0.71). Meta-analyses of standardised motor skill measurements in N=1976 individuals revealed reduced performance compared to controls in autism and language conditions (g= -0.54, p< 0.001). Together, these findings demonstrate delayed milestone attainment and motor impairments in early childhood in neurodevelopmental conditions.
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Affiliation(s)
- Aislinn Bowler
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK.
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK; Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK; MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Chloe Austerberry
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Pasco Fearon
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK; School of Psychology, University of Surrey, Guildford, UK
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Focaroli V, Taffoni F, Velardi A, Caravale B, Keller F. Object Exploration and Manipulation in Infants at Typical vs. Elevated Likelihood for ASD: A Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:825. [PMID: 39062274 PMCID: PMC11276247 DOI: 10.3390/children11070825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024]
Abstract
The present review considers the growing body of literature on fine motor skills in infants at elevated genetic likelihood (EL) for autism spectrum disorder (ASD). This area of study aims to identify crucial motor markers associated with the disorder, facilitating earlier and more accurate identification of ASD, using various experimental methodologies, including standardized assessments, observational measures, and technological tools. The reviewed evidence revealed distinct developmental trajectories in EL infants, marked by differences in fine motor skills and exploratory behaviors compared to typically developing infants. We discuss the developmental trajectory of fine motor skills in infants and their predictive value for later ASD diagnosis, highlighting the significance of fine motor skills as early indicators of ASD risk in infants and emphasizing the need for further research to elucidate their predictive value and underlying mechanisms.
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Affiliation(s)
- Valentina Focaroli
- Department of Economic, Psychological and Communication Sciences, Niccolò Cusano University, 00166 Rome, Italy
| | - Fabrizio Taffoni
- CREO LAB, Advanced Robotics and Human Centred-Technologies Laboratory, Campus Bio-Medico University, 00128 Rome, Italy;
| | - Andrea Velardi
- Department of Humanities, Motor Sciences and Education, Niccolò Cusano University, 00166 Rome, Italy;
| | - Barbara Caravale
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy;
| | - Flavio Keller
- Laboratory of Developmental Neuroscience, Campus Bio-Medico University, 00128 Rome, Italy;
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Jia SJ, Jing JQ, Yang CJ. A Review on Autism Spectrum Disorder Screening by Artificial Intelligence Methods. J Autism Dev Disord 2024:10.1007/s10803-024-06429-9. [PMID: 38842671 DOI: 10.1007/s10803-024-06429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE With the increasing prevalence of autism spectrum disorders (ASD), the importance of early screening and diagnosis has been subject to considerable discussion. Given the subtle differences between ASD children and typically developing children during the early stages of development, it is imperative to investigate the utilization of automatic recognition methods powered by artificial intelligence. We aim to summarize the research work on this topic and sort out the markers that can be used for identification. METHODS We searched the papers published in the Web of Science, PubMed, Scopus, Medline, SpringerLink, Wiley Online Library, and EBSCO databases from 1st January 2013 to 13th November 2023, and 43 articles were included. RESULTS These articles mainly divided recognition markers into five categories: gaze behaviors, facial expressions, motor movements, voice features, and task performance. Based on the above markers, the accuracy of artificial intelligence screening ranged from 62.13 to 100%, the sensitivity ranged from 69.67 to 100%, the specificity ranged from 54 to 100%. CONCLUSION Therefore, artificial intelligence recognition holds promise as a tool for identifying children with ASD. However, it still needs to continually enhance the screening model and improve accuracy through multimodal screening, thereby facilitating timely intervention and treatment.
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Affiliation(s)
- Si-Jia Jia
- Faculty of Education, East China Normal University, Shanghai, China
| | - Jia-Qi Jing
- Faculty of Education, East China Normal University, Shanghai, China
| | - Chang-Jiang Yang
- Faculty of Education, East China Normal University, Shanghai, China.
- China Research Institute of Care and Education of Infants and Young, Shanghai, China.
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Wilson RB, Vangala S, Reetzke R, Piergies A, Ozonoff S, Miller M. Objective measurement of movement variability using wearable sensors predicts ASD outcomes in infants at high likelihood for ASD and ADHD. Autism Res 2024; 17:1094-1105. [PMID: 38747403 DOI: 10.1002/aur.3150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/05/2024] [Indexed: 05/21/2024]
Abstract
Early motor delays and differences are common among children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Yet, little work has shown whether there are early atypical motor signs that differentiate these groups. Quantitative measures of movement variability hold promise for improving the identification of subtle and specific differences in motor function among infants and toddlers at high likelihood for ASD and ADHD. To this end, we created a novel quantitative measure of movement variability (movement curvature) and conducted a preliminary investigation as to whether this measure improves outcome predictions. We used a wearable triaxial accelerometer to evaluate continuous motion-based activity in infants at high and low likelihood for ASD and ADHD at 12, 18, 24, and 36 months of age. At 36 months, participants were categorized into three outcome groups: ASD (n = 19), ADHD concerns (n = 17), and a comparison group (n = 82). We examined group differences in movement curvature and whether movement curvature is predictive of a later ASD or ADHD concerns classification. We found that movement curvature was significantly lower in infants with later ASD diagnosis at 18, 24, and 36 months of age compared to infants with either ADHD concerns or those in the comparison group. Movement curvature was also a significant predictor of ASD at 18, 24, and 36 months (AUC 0.66-0.71; p = 0.005-0.039) and when adjusting for high ASD likelihood at 18 and 24 months (AUC 0.90, p = 0.05-0.019). These results indicate that lower movement curvature may be a feature of early motor differences in infants with later ASD diagnosis as early as 18 months of age.
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Affiliation(s)
- Rujuta B Wilson
- UCLA Center for Autism Research and Treatment, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Sitaram Vangala
- UCLA Department of Medicine Statistics Core, Los Angeles, California, USA
| | - Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Antonia Piergies
- UC Davis Department of Psychiatry & Biobehavioral Sciences and MIND Institute, Sacramento, California, USA
| | - Sally Ozonoff
- UC Davis Department of Psychiatry & Biobehavioral Sciences and MIND Institute, Sacramento, California, USA
| | - Meghan Miller
- UC Davis Department of Psychiatry & Biobehavioral Sciences and MIND Institute, Sacramento, California, USA
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Bowler A, Arichi T, Fearon P, Meaburn E, Begum-Ali J, Pascoe G, Johnson MH, Jones EJH, Ronald A. Phenotypic and Genetic Associations Between Preschool Fine Motor Skills and Later Neurodevelopment, Psychopathology, and Educational Achievement. Biol Psychiatry 2024; 95:849-858. [PMID: 38043695 DOI: 10.1016/j.biopsych.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Fine motor skills are heritable and comprise important milestones in development, and some evidence suggests that impairments in fine motor skills are associated with neurodevelopmental conditions, psychiatric disorders, and poor educational outcomes. METHODS In a preregistered study of 9625 preschool children from TEDS (Twins Early Development Study), fine motor assessments (drawing, block building, folding, and questionnaires) were conducted at 2, 3, and 4 years of age. A cross-age fine motor score was derived using principal component analysis. Multivariate regression analysis was used to examine the relationships between the fine motor score and neurodevelopmental traits, psychopathology, and educational outcomes at 3 later ages (7-8, 12, and 16 years) and cross-age psychopathology composite scores. Polygenic scores (PGSs) were created for attention-deficit/hyperactivity disorder (ADHD), autism, schizophrenia, anxiety, major depressive disorder, obsessive-compulsive disorder, and years of education. We ran single-PGS models and a multi-PGS model. RESULTS Fine motor skills were negatively associated with neurodevelopmental traits and psychopathology across childhood and adolescence and positively associated with educational achievement in adolescence (β = 0.25, p < .001). Superior fine motor skills were associated with a higher years-of-education PGS (β = 0.07, p < .001), a lower ADHD PGS (β = -0.04, p = .011), and a higher anxiety PGS (β = 0.03, p = .040). Similarly, the multi-PGS model retained the PGSs for years of education (β = 0.07), ADHD (β = -0.03), and anxiety (β = 0.01). A non-preregistered analysis in an independent preschool sample replicated the ADHD PGS association, but not the years of education or anxiety PGS associations. CONCLUSIONS Fine motor skills are linked genetically and phenotypically to later neurodevelopment, psychopathology, and educational outcomes. Future work should investigate the mechanisms that underlie the role of fine motor development in later outcomes.
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Affiliation(s)
- Aislinn Bowler
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom.
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom; Pediatric Neurosciences, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Pasco Fearon
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Emma Meaburn
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - Jannath Begum-Ali
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - Greg Pascoe
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom; Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Emily J H Jones
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom; School of Psychology, University of Surrey, Guildford, United Kingdom
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Luongo M, Simeoli R, Marocco D, Milano N, Ponticorvo M. Enhancing early autism diagnosis through machine learning: Exploring raw motion data for classification. PLoS One 2024; 19:e0302238. [PMID: 38648209 PMCID: PMC11034672 DOI: 10.1371/journal.pone.0302238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
In recent years, research has been demonstrating that movement analysis, utilizing machine learning methods, can be a promising aid for clinicians in supporting autism diagnostic process. Within this field of research, we aim to explore new models and delve into the detailed observation of certain features that previous literature has identified as prominent in the classification process. Our study employs a game-based tablet application to collect motor data. We use artificial neural networks to analyze raw trajectories in a "drag and drop" task. We compare a two-features model (utilizing only raw coordinates) with a four-features model (including velocities and accelerations). The aim is to assess the effectiveness of raw data analysis and determine the impact of acceleration on autism classification. Our results revealed that both models demonstrate promising accuracy in classifying motor trajectories. The four-features model consistently outperforms the two-features model, as evidenced by accuracy values (0.90 vs. 0.76). However, our findings support the potential of raw data analysis in objectively assessing motor behaviors related to autism. While the four-features model excels, the two-features model still achieves reasonable accuracy. Addressing limitations related to sample size and noise is essential for future research. Our study emphasizes the importance of integrating intelligent solutions to enhance and assist autism traditional diagnostic process and intervention, paving the way for more effective tools in assessing motor skills.
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Affiliation(s)
- Maria Luongo
- Department of Humanistic Study, Natural and Artificial Cognition Lab, University of Naples Federico II, Naples, Italy
| | - Roberta Simeoli
- Department of Humanistic Study, Natural and Artificial Cognition Lab, University of Naples Federico II, Naples, Italy
- Neapolisanit S.R.L. Research and Rehabilitation Center, Ottaviano, Naples, Italy
| | - Davide Marocco
- Department of Humanistic Study, Natural and Artificial Cognition Lab, University of Naples Federico II, Naples, Italy
| | - Nicola Milano
- Department of Humanistic Study, Natural and Artificial Cognition Lab, University of Naples Federico II, Naples, Italy
| | - Michela Ponticorvo
- Department of Humanistic Study, Natural and Artificial Cognition Lab, University of Naples Federico II, Naples, Italy
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Gentles SJ, Ng-Cordell EC, Hunsche MC, McVey AJ, Bednar ED, DeGroote MG, Chen YJ, Duku E, Kerns CM, Banfield L, Szatmari P, Georgiades S. Trajectory research in children with an autism diagnosis: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:540-564. [PMID: 37194194 PMCID: PMC10913344 DOI: 10.1177/13623613231170280] [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] [Indexed: 05/18/2023]
Abstract
LAY ABSTRACT The types of outcomes studied in children on the autism spectrum include clinical characteristics, such as social functioning, communication, language, or autism symptoms. Research that measures these outcomes at multiple timepoints is useful to improve our understanding of what to expect as children develop. In trajectory studies, researchers assess outcomes at three or more timepoints. This method has advantages over two-timepoint studies because it allows researchers to describe changes in the speed of development, such as accelerations, plateaus, or slowdowns. We identified and reviewed 103 published trajectory studies in children (to age 18 years) with an autism diagnosis. Importantly, we did not include studies of treatments or their effects, nor did we summarize the results of studies. Instead, this review summarizes the characteristics of the available published research, including the methods used, the many different outcomes that have been studied over time and the ages over which they have been studied. This summary may be of interest to autistic people and caregivers (parents) who want to know about the existence of research that provides answers about what to expect during an autistic child's development. We have recommended that future trajectory research efforts try to make up for the lack of studies from low- and middle-income countries; that more attention is given to the following outcomes that are meaningful to caregivers and autistic people; and to try to fill in the age gaps where more outcome-specific data are needed.
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Dierdorff L, Garcia-Forn M, von Mueffling A, De Rubeis S. Assessing motor development and function in mouse models of neurodevelopmental disorders. Methods Cell Biol 2024; 188:171-181. [PMID: 38880523 DOI: 10.1016/bs.mcb.2024.04.005] [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] [Indexed: 06/18/2024]
Abstract
Alterations in motor development often accompany neurodevelopmental disorders (NDD) and can have an impact on social interaction and communication. Studying motor development and function in mouse models of NDDs can offer a window to identify underlying biological mechanisms and establish preclinical outcome measures for testing therapeutics. This chapter describes tests to measure motor developmental milestones early postnatally and adult motor functions in mouse models of NDDs.
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Affiliation(s)
- Lauren Dierdorff
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Alper Center for Neural Development and Regeneration, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Marta Garcia-Forn
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Alper Center for Neural Development and Regeneration, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Alexa von Mueffling
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Alper Center for Neural Development and Regeneration, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Silvia De Rubeis
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; The Alper Center for Neural Development and Regeneration, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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Nies KJ, Baldwin J, Kaur M. Early Motor Delays During the First 2 Years of Life in Autism Spectrum Disorder: A Scoping Review. Pediatr Phys Ther 2024; 36:19-35. [PMID: 37816166 DOI: 10.1097/pep.0000000000001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
PURPOSE To summarize and appraise the emerging evidence on early motor skills of infants later diagnosed with autism spectrum disorder (ASD), and the association of early motor delays to later ASD diagnosis/characteristics. METHODS A literature search was conducted for studies published from 2000 to 2023 on the motor skills of infants later diagnosed with ASD, followed by screening and data extraction. RESULTS Current evidence suggested presence of early motor deficits including poor anticipatory movements, postural control, and gross/fine motor skills during the first 2 years of ASD. However, there was variability among studies with regard to study sample and methodology. CONCLUSION Although motor deficits are evident in infants, it is unclear whether these are specific to ASD or a consequence of general developmental disorder. Future research is needed on the investigation of specificity and severity of early motor delays, which can potentially assist in early identification of ASD.
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Affiliation(s)
- Kara J Nies
- Physical Therapy Department (Dr Nies), Cambridge Public Schools, Cambridge, Massachusetts; Physical Therapy Program (Drs Baldwin and Kaur), MGH Institute of Health Professions, Charlestown, Massachusetts
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Mosconi MW, Stevens CJ, Unruh KE, Shafer R, Elison JT. Endophenotype trait domains for advancing gene discovery in autism spectrum disorder. J Neurodev Disord 2023; 15:41. [PMID: 37993779 PMCID: PMC10664534 DOI: 10.1186/s11689-023-09511-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023] Open
Abstract
Autism spectrum disorder (ASD) is associated with a diverse range of etiological processes, including both genetic and non-genetic causes. For a plurality of individuals with ASD, it is likely that the primary causes involve multiple common inherited variants that individually account for only small levels of variation in phenotypic outcomes. This genetic landscape creates a major challenge for detecting small but important pathogenic effects associated with ASD. To address similar challenges, separate fields of medicine have identified endophenotypes, or discrete, quantitative traits that reflect genetic likelihood for a particular clinical condition and leveraged the study of these traits to map polygenic mechanisms and advance more personalized therapeutic strategies for complex diseases. Endophenotypes represent a distinct class of biomarkers useful for understanding genetic contributions to psychiatric and developmental disorders because they are embedded within the causal chain between genotype and clinical phenotype, and they are more proximal to the action of the gene(s) than behavioral traits. Despite their demonstrated power for guiding new understanding of complex genetic structures of clinical conditions, few endophenotypes associated with ASD have been identified and integrated into family genetic studies. In this review, we argue that advancing knowledge of the complex pathogenic processes that contribute to ASD can be accelerated by refocusing attention toward identifying endophenotypic traits reflective of inherited mechanisms. This pivot requires renewed emphasis on study designs with measurement of familial co-variation including infant sibling studies, family trio and quad designs, and analysis of monozygotic and dizygotic twin concordance for select trait dimensions. We also emphasize that clarification of endophenotypic traits necessarily will involve integration of transdiagnostic approaches as candidate traits likely reflect liability for multiple clinical conditions and often are agnostic to diagnostic boundaries. Multiple candidate endophenotypes associated with ASD likelihood are described, and we propose a new focus on the analysis of "endophenotype trait domains" (ETDs), or traits measured across multiple levels (e.g., molecular, cellular, neural system, neuropsychological) along the causal pathway from genes to behavior. To inform our central argument for research efforts toward ETD discovery, we first provide a brief review of the concept of endophenotypes and their application to psychiatry. Next, we highlight key criteria for determining the value of candidate endophenotypes, including unique considerations for the study of ASD. Descriptions of different study designs for assessing endophenotypes in ASD research then are offered, including analysis of how select patterns of results may help prioritize candidate traits in future research. We also present multiple candidate ETDs that collectively cover a breadth of clinical phenomena associated with ASD, including social, language/communication, cognitive control, and sensorimotor processes. These ETDs are described because they represent promising targets for gene discovery related to clinical autistic traits, and they serve as models for analysis of separate candidate domains that may inform understanding of inherited etiological processes associated with ASD as well as overlapping neurodevelopmental disorders.
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Affiliation(s)
- Matthew W Mosconi
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA.
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
| | - Cassandra J Stevens
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Kathryn E Unruh
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Robin Shafer
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Alhowikan AM, Elamin NE, Aldayel SS, AlSiddiqi SA, Alrowais FS, Hassan WM, El-Ansary A, Alghamdi FA, AL-Ayadhi LY. Children with Autism Spectrum Disorder Exhibit Elevated Physical Activity and Reduced Sedentary Behavior. Brain Sci 2023; 13:1575. [PMID: 38002535 PMCID: PMC10670306 DOI: 10.3390/brainsci13111575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
According to previous research, individuals with autism spectrum disorder (ASD) have lower levels of physical activity than their typically developed (TD) counterparts. There have been conflicting reports about physical activity (PA) levels in people with ASD. Given the conflicting evidence, further investigation is required. We believe that evaluating PA in individuals with ASD is critical in order to offer PA intervention plans aiming at increasing their health-related physical fitness on a daily, systematic, and individualized basis. In the current study, an ActiGraph monitor (GT3X+) was used to accurately measure PA and sedentary activity in 21 children with autism aged 6.43 ± 2.29 years and 30 TD children aged 7.2 ± 3.14 years. Our data indicated that while the light and moderate activity counts were not significantly different between the two groups, the vigorous activity was significantly higher in ASD compared to TD. This finding was attributed to ASD characteristic stereotypy and self-stimulating behaviors. The significantly higher vigorous PA is discussed in relation to altered neurochemistry, oxidative stress, and neuroinflammation as etiological mechanisms in ASD. This research provides a better understanding of the status of PA participation in individuals with ASD.
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Affiliation(s)
- Abdulrahman M. Alhowikan
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461, Saudi Arabia;
| | - Nadra E. Elamin
- Autism Research and Treatment Center, Department of Physiology, Faculty of Medicine, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Sarah S. Aldayel
- Department of Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (S.S.A.); (F.S.A.)
| | - Sara A. AlSiddiqi
- King Abdullah Bin Abdulaziz University Hospital (KAAUH), Riyadh 11461, Saudi Arabia;
| | - Fai S. Alrowais
- Department of Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (S.S.A.); (F.S.A.)
| | - Wail M. Hassan
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA;
| | - Afaf El-Ansary
- Autism Research and Treatment Center, Department of Physiology, Faculty of Medicine, King Saud University, Riyadh 11461, Saudi Arabia;
- Autism Center, Lotus Holistic Medical Center, Abu Dhabi P.O. Box 110281, United Arab Emirates
| | - Farah Ali Alghamdi
- College of Medicine, Dar Al-Olum University (DAU), Riyadh 13314, Saudi Arabia;
| | - Laila Y. AL-Ayadhi
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461, Saudi Arabia;
- Autism Research and Treatment Center, Department of Physiology, Faculty of Medicine, King Saud University, Riyadh 11461, Saudi Arabia;
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Alibrandi A, Zirilli A, Loschiavo F, Gangemi MC, Sindoni A, Tribulato G, Lo Giudice R, Famà F. Food Selectivity in Children with Autism Spectrum Disorder: A Statistical Analysis in Southern Italy. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1553. [PMID: 37761514 PMCID: PMC10527699 DOI: 10.3390/children10091553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
This paper focuses on autism spectrum disorder (ASD) and food selectivity, both of which are prevalent in the pediatric population. In this context, the authors paid attention to food selectivity and its possible correlation with the atypicality of sensory processes, outlining the useful rehabilitation treatments to draw on. This research included the parents or caregivers of pediatric patients diagnosed with autism spectrum disorder and placed within a therapeutic clinic. The sample is composed of 111 children, males and females, aged between 2 and 10 years, and includes 60 children diagnosed with autism and 51 children with normotypical development, similar in characteristics but without the disorder. The standardized questionnaire, "Brief Autism Mealtime Behavior Inventory", was developed to examine behavior during meals, especially in children with ASD. The "Brief Sensory Profile", and the "Child Oral and Motor Proficiency Scale", were also administered. The results obtained from the analysis lead to evidence of eating and food selectivity difficulty. Additionally, our study demonstrates that food selectivity can be caused by extreme sensory modulation and sensory problems related to the smell, texture, color, and temperature of food. In fact, the results obtained emphasize the correlation between food selectivity and the sensory domains of taste and smell. Furthermore, this research highlights a correlation between motor skills and eating skills, particularly regarding food selectivity, which is closely associated with atypical and disruptive behaviors during meals.
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Affiliation(s)
- Angela Alibrandi
- Department of Economics, University of Messina, 98122 Messina, Italy; (A.A.); (A.Z.)
| | - Agata Zirilli
- Department of Economics, University of Messina, 98122 Messina, Italy; (A.A.); (A.Z.)
| | | | | | - Alessandro Sindoni
- New Hospital of Prato S. Stefano, Azienda USL Toscana Centro, 59100 Prato, Italy;
| | - Graziella Tribulato
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98122 Messina, Italy; (G.T.); (F.F.)
| | - Roberto Lo Giudice
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98122 Messina, Italy; (G.T.); (F.F.)
| | - Fausto Famà
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98122 Messina, Italy; (G.T.); (F.F.)
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13
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Cleary DB, Maybery MT, Green C, Whitehouse AJO. The first six months of life: A systematic review of early markers associated with later autism. Neurosci Biobehav Rev 2023; 152:105304. [PMID: 37406749 DOI: 10.1016/j.neubiorev.2023.105304] [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: 12/01/2022] [Revised: 06/02/2023] [Accepted: 07/02/2023] [Indexed: 07/07/2023]
Abstract
There is now good evidence that behavioural signs of autism spectrum conditions (autism) emerge over the first two years of life. Identifying clear developmental differences early in life may facilitate earlier identification and intervention that can promote longer-term quality of life. Here we present a systematic review of studies investigating behavioural markers of later autism diagnosis or symptomology taken at 0-6 months. The following databases were searched for articles published between 01/01/2000 and 15/03/2022: Embase, Medline, Scopus, PubMed, PsycINFO, CINAHL, Web of Science and Proquest. Twenty-five studies met inclusion criteria: assessment of behaviour at 0-6 months and later assessment of autism symptomology or diagnosis. Studies examined behaviours of attention, early social and communication behaviours, and motor behaviours, as well as composite measures. Findings indicated some evidence of measures of general attention, attention to social stimuli, and motor behaviours associated with later autism diagnosis or symptomology. Findings were inconsistent regarding social and communication behaviours, with a lack of repeated or validated measures limiting drawing firm conclusions. We discuss implications of the findings and suggest recommendations for future research.
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Affiliation(s)
- Dominique B Cleary
- Telethon Kids Institute, The University of Western Australia, Australia; School of Psychological Science, The University of Western Australia, Australia.
| | - Murray T Maybery
- School of Psychological Science, The University of Western Australia, Australia
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14
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Fertan E, Wong AA, Montbrun TSGD, Purdon MK, Roddick KM, Yamamoto T, Brown RE. Early postnatal development of the MDGA2 +/- mouse model of synaptic dysfunction. Behav Brain Res 2023; 452:114590. [PMID: 37499910 DOI: 10.1016/j.bbr.2023.114590] [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: 05/05/2023] [Revised: 06/13/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
Synaptic dysfunction underlies many neurodevelopmental disorders (NDDs). The membrane-associated mucin domain-containing glycosylphosphatidylinositol anchor proteins (MDGAs) regulate synaptic development by modulating neurexin-neuroligin complex formation. Since understanding the neurodevelopmental profile and the sex-based differences in the manifestation of the symptoms of NDDs is important for their early diagnosis, we tested a mouse model haploinsufficient for MDGA2 (MDGA2+/-) on a neurodevelopmental test battery, containing sensory, motor, and cognitive measures, as well as ultrasonic vocalizations. When male and female MDGA2+/- and wildtype (WT) C57BL/6 J mice were examined from 2 to 23 days of age using this test battery, genotype and sex differences in body weight, sensory-motor processes, and ultrasonic vocalizations were observed. The auditory startle reflex appeared earlier in the MDGA2+/- than in WT mice and the MDGA2+/- mice produced fewer ultrasonic vocalizations. The MDGA2+/- mice showed reduced locomotion and rearing than WT mice in the open field after 17 days of age and spent less time investigating a novel object than WT mice at 21 days of age. Female MDGA2+/- mice weighed less than WT females and showed lower grip strength, indicating a delay in sensory-motor development in MDGA2+/- mice, which appears to be more pronounced in females than males. The behavioural phenotypes resulting from MDGA2 haploinsufficiency suggests that it shows delayed development of motor behaviour, grip strength and exploratory behaviour, non-social phenotypes of NDDs.
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Affiliation(s)
- Emre Fertan
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Aimée A Wong
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | | | - Michaela K Purdon
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Kyle M Roddick
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Tohru Yamamoto
- Department of Molecular Neurobiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kagawa 761-0793, Japan
| | - Richard E Brown
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada.
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15
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Cho S, Samuel TM, Li T, Howell BR, Baluyot K, Hazlett HC, Elison JT, Zhu H, Hauser J, Sprenger N, Lin W. Interactions between Bifidobacterium and Bacteroides and human milk oligosaccharides and their associations with infant cognition. Front Nutr 2023; 10:1216327. [PMID: 37457984 PMCID: PMC10345227 DOI: 10.3389/fnut.2023.1216327] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
While ample research on independent associations between infant cognition and gut microbiota composition and human milk (HM) oligosaccharides (HMOs) has been reported, studies on how the interactions between gut microbiota and HMOs may yield associations with cognitive development in infancy are lacking. We aimed to determine how HMOs and species of Bacteroides and Bifidobacterium genera interact with each other and their associations with cognitive development in typically developing infants. A total of 105 mother-infant dyads were included in this study. The enrolled infants [2.9-12 months old (8.09 ± 2.48)] were at least predominantly breastfed at 4 months old. A total of 170 HM samples from the mothers and fecal samples of the children were collected longitudinally. Using the Mullen Scales of Early Learning to assess cognition and the scores as the outcomes, linear mixed effects models including both the levels of eight HMOs and relative abundance of Bacteroides and Bifidobacterium species as main associations and their interactions were employed with adjusting covariates; infant sex, delivery mode, maternal education, site, and batch effects of HMOs. Additionally, regression models stratifying infants based on the A-tetrasaccharide (A-tetra) status of the HM they received were also employed to determine if the associations depend on the A-tetra status. With Bacteroides species, we observed significant associations with motor functions, while Bif. catenulatum showed a negative association with visual reception in the detectable A-tetra group both as main effect (value of p = 0.012) and in interaction with LNFP-I (value of p = 0.007). Additionally, 3-FL showed a positive association with gross motor (p = 0.027) and visual reception (p = 0.041). Furthermore, significant associations were observed with the interaction terms mainly in the undetectable A-tetra group. Specifically, we observed negative associations for Bifidobacterium species and LNT [breve (p = 0.011) and longum (p = 0.022)], and positive associations for expressive language with 3'-SL and Bif. bifidum (p = 0.01), 6'-SL and B. fragilis (p = 0.019), and LNFP-I and Bif. kashiwanohense (p = 0.048), respectively. Our findings suggest that gut microbiota and HMOs are both independently and interactively associated with early cognitive development. In particular, the diverse interactions between HMOs and Bacteroides and Bifidobacterium species reveal different candidate pathways through which HMOs, Bifidobacterium and Bacteroides species potentially interact to impact cognitive development in infancy.
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Affiliation(s)
- Seoyoon Cho
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tinu M. Samuel
- Nestle Product Technology Center-Nutrition, Société des Produits Nestlé S.A., Vevey, Switzerland
| | - Tengfei Li
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brittany R. Howell
- Fralin Biomedical Research Institute at VTC, Department of Human Development and Family Science, Virginia Polytechnic Institute and State University, Roanoke, VA, United States
| | - Kristine Baluyot
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Heather C. Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, United States
| | - Hongtu Zhu
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jonas Hauser
- Nestlé Institute of Health Sciences, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Norbert Sprenger
- Nestlé Institute of Health Sciences, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Weili Lin
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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16
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McGlade A, Whittingham K, Barfoot J, Taylor L, Boyd RN. Efficacy of very early interventions on neurodevelopmental outcomes for infants and toddlers at increased likelihood of or diagnosed with autism: A systematic review and meta-analysis. Autism Res 2023; 16:1145-1160. [PMID: 37036800 PMCID: PMC10946707 DOI: 10.1002/aur.2924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 03/18/2023] [Indexed: 04/11/2023]
Abstract
The aim of this systematic review was to determine the efficacy of very early interventions for infants and toddlers at increased likelihood of or diagnosed with autism for autism symptomatology, developmental outcomes and/or neurocognitive markers. Eight databases were searched (14 April 2022) with inclusion criteria: (i) RCTs with care as usual (CAU) comparison group, (ii) participants at increased likelihood of or diagnosed with autism and aged <24 months corrected age (CA), (iii) parent-mediated and/or clinician directed interventions, and (iv) outcome measures were autism symptomatology, cognition, language, adaptive skills, or neurocognitive assessments (EEG and eye tracking). Quality was assessed using Risk of Bias 2 and GRADE. Nineteen publications from 12 studies reported on 715 infants and toddlers. There was low to moderate certainty evidence that clinician-assessed outcomes did not show significant treatment effects for: autism symptomatology (ADOS CSS: MD -0.08, 95% CI -0.61, 0.44, p = 0.75), cognitive outcome (Mullen Scales of Early Learning-Early Learning Composite (MSEL-ELC): SMD 0.05, 95% CI -0.19, 0.29, p = 0.67), receptive language (MSEL-Receptive Language: SMD 0.04, 95% CI -0.21, 0.3, p = 0.74) or expressive language (MSEL-Expressive Language: SMD 0.06, 95% CI -0.1, 0.23, p = 0.45). Neurocognitive outcomes (EEG and eye tracking) were heterogeneous, with inconsistent findings. There is low to moderate certainty evidence that very early interventions have limited impact on neurodevelopmental outcomes by age 3 years.
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Affiliation(s)
- Andrea McGlade
- Faculty of MedicineThe University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research CentreBrisbaneQueenslandAustralia
| | - Koa Whittingham
- Faculty of MedicineThe University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research CentreBrisbaneQueenslandAustralia
| | - Jacqui Barfoot
- Faculty of MedicineThe University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research CentreBrisbaneQueenslandAustralia
| | - Leisa Taylor
- Department of Humanities EducationUniversity of New EnglandArmidaleNew South WalesAustralia
| | - Roslyn N. Boyd
- Faculty of MedicineThe University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research CentreBrisbaneQueenslandAustralia
- Queensland Paediatric Rehabilitation ServiceQueensland Children's HospitalBrisbaneQueenslandAustralia
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17
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Godel M, Robain F, Journal F, Kojovic N, Latrèche K, Dehaene-Lambertz G, Schaer M. Prosodic signatures of ASD severity and developmental delay in preschoolers. NPJ Digit Med 2023; 6:99. [PMID: 37248317 DOI: 10.1038/s41746-023-00845-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/15/2023] [Indexed: 05/31/2023] Open
Abstract
Atypical prosody in speech production is a core feature of Autism Spectrum Disorder (ASD) that can impact everyday life communication. Because the ability to modulate prosody develops around the age of speech acquisition, it might be affected by ASD symptoms and developmental delays that emerge at the same period. Here, we investigated the existence of a prosodic signature of developmental level and ASD symptom severity in a sample of 74 autistic preschoolers. We first developed an original diarization pipeline to extract preschoolers' vocalizations from recordings of naturalistic social interactions. Using this novel approach, we then found a robust voice quality signature of ASD developmental difficulties in preschoolers. Furthermore, some prosodic measures were associated with one year later outcome in participants who had not acquired speech yet. Altogether, our results highlight the potential benefits of automatized diarization algorithms and prosodic metrics for digital phenotyping in psychiatry, helping clinicians establish early diagnosis and prognosis.
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Affiliation(s)
- Michel Godel
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland.
| | - François Robain
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Fiona Journal
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Nada Kojovic
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Kenza Latrèche
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit, CNRS ERL 9003, INSERM U992, CEA, Université Paris-Saclay, NeuroSpin Center, Gif/Yvette, France
| | - Marie Schaer
- Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
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18
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Butler LK, Tager-Flusberg H. Fine motor skill and expressive language in minimally verbal and verbal school-aged autistic children. Autism Res 2023; 16:630-641. [PMID: 36578205 PMCID: PMC10320849 DOI: 10.1002/aur.2883] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/13/2022] [Indexed: 12/30/2022]
Abstract
Fine motor skill is associated with expressive language outcomes in infants who have an autistic sibling and in young autistic children. Fewer studies have focused on school-aged children even though around 80% have motor impairments and 30% remain minimally verbal (MV) into their school years. Moreover, expressive language is not a unitary construct, but it is made up of components such as speech production, structural language, and social-pragmatic language use. We used natural language sampling to investigate the relationship between fine motor and speech intelligibility, mean length of utterance and conversational turns in MV and verbal autistic children between the ages of 4 and 7 while controlling for age and adaptive behavior. Fine motor skill predicted speech production, measured by percent intelligible utterances. Fine motor skill and adaptive behavior predicted structural language, measured by mean length of utterance in morphemes. Adaptive behavior, but not fine motor skill, predicted social-pragmatic language use measured by number of conversational turns. Simple linear regressions by group corrected for multiple comparisons showed that fine motor skill predicted intelligibility for MV but not verbal children. Fine motor skill and adaptive behavior predicted mean length of utterance for both MV and verbal children. These findings suggest that future studies should explore whether MV children may benefit from interventions targeting fine motor along with speech and language into their school years.
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Affiliation(s)
- Lindsay K. Butler
- Boston University Psychological & Brain Sciences 64 Cummington Mall Boston MA 02215 USA
| | - Helen Tager-Flusberg
- Boston University Psychological & Brain Sciences 64 Cummington Mall Boston MA 02215 USA
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19
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Bhat A, Tulsky DS, Boulton AJ. Cross-replicating findings on unique motor impairments of children with ASD using confirmatory factor analysis and a novel SPARK study sample. Autism Res 2023; 16:967-980. [PMID: 36840933 DOI: 10.1002/aur.2904] [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: 07/15/2022] [Accepted: 02/09/2023] [Indexed: 02/26/2023]
Abstract
A series of recent reports have shed light on the pervasive nature of motor impairments in children with ASD (Bhat, 2020, 2021, Bhat et al., 2022), underscoring the importance of providing ASD clinicians efficient and accurate tools for motor screening. The Developmental Coordination Disorder-Questionnaire (DCD-Q) is a widely used motor screening tool, yet scant evidence exists regarding its psychometric properties in children with ASD. In a recent Exploratory Factor Analysis (EFA) of the 15-item DCD-Q in a large sample of children with ASD (SPARK study), we found a 5-factor latent structure that identified unique motor impairments in a large sample of children with ASD (Bhat et al., 2022). In the current study, we extend this work by cross-replicating the EFA findings of unique ASD-related motor issues using Confirmatory Factor Analysis (CFA) in a new, more recent wave of children with ASD from the SPARK study (N = 9721). The fits and interpretability of 11 hypothesis-driven CFA models, including 8 correlated-factors, 1 second-order, and 2 bifactor models were compared. Our findings supported the previous 5-factor model with 2 gross motor subdomains, 1 fine motor domain (similar to the original DCD-Q) and 2 general coordination subdomains. This model demonstrated acceptable fit in the new sample as well as superior fit compared to several other parsimonious correlated-factors models. However, the second-order and bifactor models fit slightly better and supported the presence of a general motor skills factor, although 38% of the common variance in the DCD-Q items remained attributable to the 5 subdomains. Using one of the bifactor models, measurement invariance was also supported for DCD-Q across sex, race, and co-occurring conditions of language disorder and intellectual disability. Only partial invariance was supported when testing DCD-Q scores across different age groups. These findings reveal a more complex dimensional picture of the DCD-Q in children with ASD. Results suggest that the DCD-Q can be used in two ways, total scores adequately assess general motor skills for brief screening and subdomain scores offer unique information on the multidimensional motor problems of children with ASD. If subdomain data are of interest, our findings call into question the practice of relying on 3 original subscales of the DCD-Q when screening for ASD-related motor difficulties, whereas 4 out of 5 subscale scores may better highlight domain-specific motor problems. Future studies should continue to further validate DCD-Q's ability to screen for multidimensional motor problems.
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Affiliation(s)
- Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - David S Tulsky
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA.,Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - Aaron J Boulton
- Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
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20
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Perochon S, Matias Di Martino J, Carpenter KLH, Compton S, Davis N, Espinosa S, Franz L, Rieder AD, Sullivan C, Sapiro G, Dawson G. A tablet-based game for the assessment of visual motor skills in autistic children. NPJ Digit Med 2023; 6:17. [PMID: 36737475 PMCID: PMC9898502 DOI: 10.1038/s41746-023-00762-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/21/2023] [Indexed: 02/05/2023] Open
Abstract
Increasing evidence suggests that early motor impairments are a common feature of autism. Thus, scalable, quantitative methods for measuring motor behavior in young autistic children are needed. This work presents an engaging and scalable assessment of visual-motor abilities based on a bubble-popping game administered on a tablet. Participants are 233 children ranging from 1.5 to 10 years of age (147 neurotypical children and 86 children diagnosed with autism spectrum disorder [autistic], of which 32 are also diagnosed with co-occurring attention-deficit/hyperactivity disorder [autistic+ADHD]). Computer vision analyses are used to extract several game-based touch features, which are compared across autistic, autistic+ADHD, and neurotypical participants. Results show that younger (1.5-3 years) autistic children pop the bubbles at a lower rate, and their ability to touch the bubble's center is less accurate compared to neurotypical children. When they pop a bubble, their finger lingers for a longer period, and they show more variability in their performance. In older children (3-10-years), consistent with previous research, the presence of co-occurring ADHD is associated with greater motor impairment, reflected in lower accuracy and more variable performance. Several motor features are correlated with standardized assessments of fine motor and cognitive abilities, as evaluated by an independent clinical assessment. These results highlight the potential of touch-based games as an efficient and scalable approach for assessing children's visual-motor skills, which can be part of a broader screening tool for identifying early signs associated with autism.
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Affiliation(s)
- Sam Perochon
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA
- Ecole Normale Supérieure Paris-Saclay, Gif-Sur-Yvette, France
| | - J Matias Di Martino
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA
| | - Kimberly L H Carpenter
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - Scott Compton
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - Naomi Davis
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Steven Espinosa
- Office of Information Technology, Duke University, Durham, NC, USA
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Amber D Rieder
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - Connor Sullivan
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - Guillermo Sapiro
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA.
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA.
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21
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Bhat A. Multidimensional motor performance in children with autism mostly remains stable with age and predicts social communication delay, language delay, functional delay, and repetitive behavior severity after accounting for intellectual disability or cognitive delay: A SPARK dataset analysis. Autism Res 2023; 16:208-229. [PMID: 36533674 PMCID: PMC9939031 DOI: 10.1002/aur.2870] [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: 08/26/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
When motor difficulties continue into adolescence/adulthood, they could negatively impact an individual with autism spectrum disorder (ASD)'s daily living skills, physical fitness, as well as physical and mental health/well-being. Few studies have examined motor difficulties in children with ASD as a function of sex or age; however, greater cognitive challenges are associated with worse general motor performance. Based on the Developmental Coordination Disorder-Questionnaire (DCD-Q) data from the SPARK study sample, 87%-88% children with ASD were at-risk for a general motor impairment that persisted until 15 years and was related to their core and co-occurring difficulties. Bhat et al. confirmed motor difficulties in children with ASD on multiple motor dimensions that predicted core and co-occurring conditions after accounting for age and sex. However, presence of intellectual disability (ID) or cognitive delay was not controlled in the previous analysis. Additionally, the effects of age, sex, and cognitive ability on multidimensional motor difficulties of the SPARK sample have not been discussed before. Therefore, this analysis examines the effects of age, sex, and cognitive ability (presence of ID or level of cognitive delay) on the motor performance of children from the SPARK sample using the DCD-Q. Except fine motor skills, multiple motor domains did not change with age in children with ASD. Females without ID improved their fine motor scores with age, and performed better compared to males without ID. Children with ASD and ID had greater motor difficulties across multiple motor domains than those without ID. Even after controlling for age, sex, and presence of ID/cognitive delay; motor performance was predictive of social communication skills, repetitive behavior severity, as well as language and functional delays. Gross motor skills contributed more than fine motor and general motor competence skills in predicting social communication delay. However, fine motor and general motor competence skills contributed more than gross motor skills in predicting repetitive behavior severity and language delay. Both, fine and gross motor skills predicted functional delay. In light of consistent findings on motor difficulties in children with ASD, adding motor issues as a specifier within the ASD definition could provide a clear clinical route for movement clinicians to address motor difficulties of individuals with ASD.
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Affiliation(s)
- Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
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22
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Deserno MK, Fuhrmann D, Begeer S, Borsboom D, Geurts HM, Kievit RA. Longitudinal development of language and fine motor skills is correlated, but not coupled, in a childhood atypical cohort. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:133-144. [PMID: 35470698 PMCID: PMC9806469 DOI: 10.1177/13623613221086448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
LAY ABSTRACT More and more members of the autistic community and the research field are moving away from the idea that there will be a single biological or cognitive explanation for autistic characteristics. However, little is known about the complex dynamic processes that could explain why early difficulties in the language and motor domain often go hand-in-hand. We here study how language and motor skills develop simultaneously in the British Autism Study of Infant Siblings cohort of infants, and compare the way they are linked between children with and without developmental delays. Our results suggest that improvements in one domain go hand-in-hand with improvements in the other in both groups and show no compelling evidence for group differences in how motor skills relate to language and vice versa. We did observe a larger diversity in motor and language skills at 6 months, and because we found the motor and language development to be tightly linked, this suggests that even very small early impairments can result in larger developmental delays in later childhood. Greater variability at baseline, combined with very strong correlations between the slopes, suggests that dynamic processes may amplify small differences between individuals at 6months to result into large individual differences in autism symptomatology at 36 months.
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Affiliation(s)
- Marie K Deserno
- Dr. Leo Kannerhuis and REACH-AUT, The
Netherlands,University of Amsterdam, The
Netherlands,Max Planck Institute for Human
Development, Germany,Marie K Deserno, Max Planck Institute for
Human Development, Postbus 15933, Amsterdam, 1001 NK, The Netherlands.
| | | | | | | | - Hilde M Geurts
- Dr. Leo Kannerhuis and REACH-AUT, The
Netherlands,University of Amsterdam, The
Netherlands
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23
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Garrido D, Carballo G. Linguistic and motor profiles in preschool and school-age children with an older sibling with autism spectrum disorder. JOURNAL OF CHILD LANGUAGE 2022:1-19. [PMID: 36472207 DOI: 10.1017/s0305000922000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This study examines receptive-expressive language, gross-fine motor skills, and IQ abilities in 78 children, 43 children with an older sibling with autism spectrum disorder (Sibs-ASD) and 35 children with an older sibling with typical development, ranging from 4 to 11 years of age. Depending on age, both groups were divided in preschool and school groups. The results show that more than 76% of Sibs-ASD performed at least one language and/or motor skill under 25th percentile. Significant differences were described at preschool stage in three aspects: grammatical comprehension, ball skills, and global motor skills. At school age, significant differences were found in two aspects: expressive language, and ball skills. Some differences seem to decrease over time; meanwhile others seem to increase; and others remain stable. Thus, it seems that vulnerability continues in unaffected Sibs-ASD and suggest that this population may benefit from continued screening and monitoring into the preschool and school-age stages.
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Affiliation(s)
- Dunia Garrido
- University of Granada, Faculty of Psychology Granada18071Spain
| | - Gloria Carballo
- University of Granada, Faculty of Psychology Granada18071Spain
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24
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Yoshimura Y, Hasegawa C, Tanaka S, Ikeda T, Yaoi K, Iwasaki S, An K, Kikuchi M. Altered sensory integration from body and language development in children with autism spectrum disorder. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e64. [PMID: 38868651 PMCID: PMC11114361 DOI: 10.1002/pcn5.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/30/2022] [Accepted: 11/19/2022] [Indexed: 06/14/2024]
Abstract
Aim Although atypical sensory motor processing has been investigated in children with autism spectrum disorder (ASD), whether or not atypical sensory motor processing is related to altered language function in children with ASD remains unclear. Methods This study examined the relationship between sensory motor processing and language conceptual inference ability in 3-10-year-old children with (n = 61) and without (n = 114) ASD. Language performance was assessed using the language conceptual inference task of the Kaufman Assessment Battery for Children (K-ABC). Sensory processing was assessed using the Caregiver Sensory Profile. Results In children with ASD, altered processing of the fine motor/perceptual factor scored by sensory profile was found to be significantly related to language conceptual inference ability in the K-ABC, representing the integrated abilities of language comprehension and language expression, which reflect language semantic concept formation. Conclusions For children with ASD, the results suggest a relationship between difficulties of integrating sensory information perceived from the body adjusting fine movement and deficiencies of language semantic conceptual formation.
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Affiliation(s)
- Yuko Yoshimura
- Institute of Human and Social SciencesKanazawa UniversityKanazawaJapan
- Research Center for Child Mental DevelopmentKanazawa UniversityKanazawaJapan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of MedicineChiba University, and University of FukuiOsaka/Kanazawa/Hamamatsu/Chiba/FukuiJapan
| | - Chiaki Hasegawa
- Research Center for Child Mental DevelopmentKanazawa UniversityKanazawaJapan
- Japan Society for the Promotion of ScienceChiyoda‐kuTokyoJapan
- Department of Cognitive ScienceMacquarie UniversitySydneyAustralia
| | - Sanae Tanaka
- Research Center for Child Mental DevelopmentKanazawa UniversityKanazawaJapan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of MedicineChiba University, and University of FukuiOsaka/Kanazawa/Hamamatsu/Chiba/FukuiJapan
| | - Takashi Ikeda
- Research Center for Child Mental DevelopmentKanazawa UniversityKanazawaJapan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of MedicineChiba University, and University of FukuiOsaka/Kanazawa/Hamamatsu/Chiba/FukuiJapan
| | - Ken Yaoi
- Research Center for Child Mental DevelopmentKanazawa UniversityKanazawaJapan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of MedicineChiba University, and University of FukuiOsaka/Kanazawa/Hamamatsu/Chiba/FukuiJapan
| | - Sumie Iwasaki
- Research Center for Child Mental DevelopmentKanazawa UniversityKanazawaJapan
| | - Kyung‐min An
- School of PsychologyUniversity of BirminghamBirminghamUK
- Centre for Human Brain Health, School of PsychologyUniversity of BirminghamBirminghamUK
| | - Mitsuru Kikuchi
- Research Center for Child Mental DevelopmentKanazawa UniversityKanazawaJapan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of MedicineChiba University, and University of FukuiOsaka/Kanazawa/Hamamatsu/Chiba/FukuiJapan
- Department of Psychiatry and Neurobiology, Graduate School of Medical ScienceKanazawa UniversityKanazawaJapan
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25
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Calabretta BT, Schneider JL, Iverson JM. Bidding on the go: Links between walking, social actions, and caregiver responses in infant siblings of children with autism spectrum disorder. Autism Res 2022; 15:2324-2335. [PMID: 36254470 DOI: 10.1002/aur.2830] [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: 04/25/2022] [Accepted: 09/29/2022] [Indexed: 12/15/2022]
Abstract
The development of walking is associated with a shift in how neurotypical infants initiate social interactions. Walking infants are more likely to locate objects in distant places, carry them, and then share those objects by approaching caregivers and using gestures to show or offer their discoveries (i.e., moving bids). The simultaneous organization of the behaviors necessary to generate moving bids requires the coordination of multiple skills-walking, fine motor skills, and gesturing. Infants with an elevated likelihood (EL) for autism spectrum disorder (ASD) exhibit differences and delays in each of these behaviors. This study investigated interconnections between infant walking, social actions, and caregiver responses in 18-month-old EL infants with diverse developmental outcomes (ASD, non-ASD language delay, no diagnosis). We observed 85 infant-caregiver dyads at home during everyday activities for 45 minutes and identified all times when infants walked, instances of walking paired with social action (i.e., approaching the caregiver, approaching while carrying an object, producing a moving bid), and whether caregivers responded to their infants' social actions. There were no group differences in infants' production of social actions. Caregiver responses, however, were more clearly modulated by outcome group. While all caregivers were similarly and highly likely to respond to moving bids, caregivers of EL-ASD infants were substantially more likely to respond when their infants simply approached them (with or without an object in hand). Taken together, this research underscores the complexity of EL infant-caregiver interactions and highlights the role that each partner plays in shaping how they unfold.
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Affiliation(s)
- Bianca T Calabretta
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joshua L Schneider
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jana M Iverson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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26
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Stabile M, Eigsti IM. Lexical Alignment and Communicative Success in Autism Spectrum Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4300-4305. [PMID: 36260779 PMCID: PMC9940884 DOI: 10.1044/2022_jslhr-22-00314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Typical speakers tend to adopt words used by their conversational partners. This "lexical alignment" enhances communication by reducing ambiguity and promoting a shared understanding of the topic under discussion. Lexical alignment has been little studied to date in autism spectrum disorder (ASD); furthermore, it has been studied primarily via structured laboratory tasks that may overestimate performance. This study examined lexical alignment in ASD during discourse and explored associations with communicative success and executive function. METHOD Thirty-one autistic and nonautistic adolescents were paired with a study-naïve research assistant (RA) to complete a social communication task that involved taking turns verbally instructing (guiding) the partner to navigate on a map. Lexical alignment was operationalized as the proportion of shared vocabulary produced by guides on successive maps. Task accuracy was operationalized as the pixels contained within the intended and drawn routes. RESULTS Results indicated that autistic adolescents had greater difficulty describing navigational routes to RAs, yielding paths that were less accurate. Alignment was reduced in autistic participants, and it was associated with path accuracy for nonautistic, but not autistic, adolescents. The association between lexical alignment and executive function missed significance (p = .05); if significant, the association would indicate that greater executive function difficulty was associated with reduced lexical alignment. CONCLUSIONS These findings provide preliminary evidence of reduced lexical alignment in ASD in an unstructured discourse context. Moreover, positive associations between lexical alignment and task performance in the neurotypical group raise the possibility that interventions to promote the use of shared vocabulary might support better communication. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21313719.
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Affiliation(s)
- Mackenzie Stabile
- Department of Psychological Sciences, University of Connecticut, Storrs
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs
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27
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Pant SW, Skovgaard AM, Ammitzbøll J, Holstein BE, Pedersen TP. Motor development problems in infancy predict mental disorders in childhood: a longitudinal cohort study. Eur J Pediatr 2022; 181:2655-2661. [PMID: 35384508 DOI: 10.1007/s00431-022-04462-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/26/2022] [Accepted: 03/31/2022] [Indexed: 11/03/2022]
Abstract
UNLABELLED The purpose of this study is to examine whether motor development problems in infancy predicted mental disorders later in childhood, taking a wide array of potential confounding variables into consideration. This longitudinal study included an unselected study population of 33238 newborn children from the Copenhagen area, Denmark. Data on the predictor variable, motor development problems at 8-10 months of age, were obtained from the community health nurses' systematic evaluation of the child's motor development during a home visit and stored in the Child Health Database. Data on outcome, diagnosed mental disorders before the age of 8 years, were obtained from the Danish National Patient Register. Potential confounding variables were obtained from the Child Health Database, the National Birth Register and the Civil Registration System. The prevalence of motor development problems at 8-10 months of age was 19.3%; the incidence of any diagnosed mental disorder from 11 months of age to the 8th birthday was 4.0%. Motor development problems were associated with an increased risk of being diagnosed with a mental disorder before the 8th birthday, adjusted odds ratio (AOR) 1.47 (1.29-1.67). Motor development problems were associated with later neurodevelopmental disorders, AOR 1.77 (1.52-2.06), in particular autism spectrum disorders, AOR 1.63 (1.31-2.03), hyperactivity/attention deficit disorders, AOR 1.29 (1.03-1.61) and disorders of intellectual disability, AOR 3.28 (2.39-4.49). CONCLUSION Motor development problems as early at 8-10 months of age were predictive of neurodevelopmental disorders before the 8th birthday. The findings call for clinical attention and more research on preventive potentials in the community child health care. WHAT IS KNOWN • Children with ASD, ADHD and ID have high prevalence of early motor development problems. WHAT IS NEW • Motor development problems in infancy predicted neurodevelopmental disorders before the 8th birthday. • This observation could improve early identification and prevention of mental health problems in childhood.
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Affiliation(s)
- Sofie Weber Pant
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Janni Ammitzbøll
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Bjørn E Holstein
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark.
| | - Trine Pagh Pedersen
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
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28
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Early signs of autism in infants whose mothers suffered from a threatened preterm labour: a 30-month prospective follow-up study. Eur Child Adolesc Psychiatry 2022; 31:1-13. [PMID: 33689027 DOI: 10.1007/s00787-021-01749-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/17/2021] [Indexed: 01/22/2023]
Abstract
Infants born after a threatened preterm labour (TPL infants) are at high risk of autism spectrum disorder (ASD). Studying this population may provide insight on the pathophysiological underpinnings of this condition. This study aimed to (i) ascertain the presence and autistic symptom load in TPL infants aged age 30 months relative to non-TPL infants, regardless of preterm birth; (ii) explore the association between early (at 6 months) psychomotor development and temperament features with the autistic symptom load of TPL infants at age 30 months and (iii) examine the association among perinatal risk factors for ASD development with the autistic symptom load of TPL infants at age 30 months. A group of 111 mother-infant pairs recruited at TPL diagnosis and a group of 47 healthy mother-infant controls completed the follow-up. Irrespective of preterm birth, TPL infants showed higher autistic symptom load at age 30 months than non-TPL infants. TPL infants presented poorer communication and problem-solving skills, reduced smiling and laughter, and greater vocal reactivity at age 6 months, predicting higher autistic symptom load at age 30 months. Higher levels of anxiety symptoms in TPL mothers after a TPL diagnosis also predicted higher autistic symptom load for the infants at age 30 months. These results suggest that TPL infants may be an undescribed cluster, with features that differentiate them from other "at-risk" populations. These findings support the need for routine assessment of TPL infants and screening of anxiety symptoms in mothers.
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29
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Pecukonis M, Young GS, Brian J, Charman T, Chawarska K, Elsabbagh M, Iverson JM, Jeste S, Landa R, Messinger DS, Schwichtenberg A, Webb SJ, Zwaigenbaum L, Tager-Flusberg H. Early predictors of language skills at 3 years of age vary based on diagnostic outcome: A baby siblings research consortium study. Autism Res 2022; 15:1324-1335. [PMID: 35652157 PMCID: PMC9253079 DOI: 10.1002/aur.2760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/11/2022] [Indexed: 11/08/2022]
Abstract
While previous work has identified the early predictors of language skills in infants at elevated familial risk (ER) and low familial risk (LR) for autism spectrum disorder (ASD), no studies to date have explored whether these predictors vary based on diagnostic outcome of ASD or no ASD. The present study used a large, multisite dataset to examine associations between a set of commonly studied predictor variables (infant gesture abilities, fine motor skills, nonverbal cognition, and maternal education level), measured at 12 months, and language skills, measured at 3 years, across three diagnostic outcome groups-infants with ASD ("ASD"), ER infants without ASD ("ER-no ASD"), and LR infants without ASD ("LR-no ASD"). Findings revealed that the predictors of language skills differed across groups, as gesture abilities were positively associated with language skills in the ER-no ASD group but negatively associated with language skills in the ASD group. Furthermore, maternal education level was positively associated with language skills in the ASD and LR-no ASD groups only. Variability in these early predictors may help explain why language skills are heterogeneous across the autism spectrum, and, with further study, may help clinicians identify those in need of additional and/or specialized intervention services that support language development. LAY SUMMARY: The present study identified predictors of language skills in infants with and without autism spectrum disorder (ASD). Maternal education level and 12-month gesture abilities predicted 3-year language skills in infants with ASD. Measuring these predictors early in life may help identify infants and families in need of additional and/or specialized intervention services that support language development.
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Affiliation(s)
| | - Gregory S. Young
- Department of Psychiatry and Behavioral Sciences, University of California Davis
| | | | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London
| | | | | | | | - Shafali Jeste
- Department of Pediatrics, Department of Neurology, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute
| | | | | | - Sara Jane Webb
- Psychiatry and Behavioral Sciences, University of Washington
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30
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Zhang Q, Li Q, Yang T, Chen L, Dai Y, Wei H, Wang K, Jia F, Wu L, Hao Y, Li L, Zhang J, Ke X, Yi M, Hong Q, Chen J, Fang S, Wang Y, Wang Q, Jin C, Chen J, Li T. Neurodevelopmental domain characteristics and their association with core symptoms in preschoolers with autism spectrum disorder in China: a nationwide multicenter study. BMC Psychiatry 2022; 22:393. [PMID: 35698058 PMCID: PMC9195470 DOI: 10.1186/s12888-022-04028-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a group of clinically heterogenic neurodevelopmental disorders, with intellectual disability being one of its common comorbidities. No large-sample, multicenter study has focused on the neurodevelopmental aspect of preschoolers with ASD. This study investigated the neurodevelopmental characteristics of preschoolers with ASD in China and explored the association between them and the core symptoms. METHODS We enrolled 1019 ASD preschoolers aged 2-7 years old from 13 cities around China between May 2018 and December 2019, and used the revised Children Neuropsychological and Behavior Scale (CNBS-R2016) to assess their neurodevelopment. Their autistic core behaviors were evaluated based on their Social Responsiveness Scale (SRS), Autism Behavior Checklist (ABC), Child Autism Rating Scale (CARS), and communication warning behavior (CWB) scores in the CNBS-R2016. RESULTS Based on general developmental quotient (GQ) < 70, 68.4% of the preschoolers with ASD had a developmental delay (DD), rated mild in 32.7% of them. The highest DD rate (> 70%) was found in language and personal-social skills, followed by fine motor skills (68.9%). Gross motor skills had the lowest DD rate (34.0%). We found that fine motor, language, and personal-social developmental quotients (DQs) were significantly lower than gross motor skills in no DD (GQ > 70), mild DD (GQ 55-69), and moderate and below DD groups (GQ ≤ 54). Furthermore, the DQs for language and personal-social skills were significantly lower than for gross and fine motor skills in both DD groups. The ABC, SRS, CARS, and CWB scores in the no DD group were the lowest, moderate in the mild DD group, and highest in the moderate and below DD group. Besides, negative correlations were found between the DQs of the four domains and the ABC, SRS, CARS, and CWB scores, of which the language and personal-social skills DQs had the strongest correlations. CONCLUSIONS Preschoolers with ASD had unbalanced neurodevelopment domain patterns and their neurodevelopmental levels were negatively correlated with the autism core symptoms. Hence, pediatricians should actively evaluate the neurodevelopment of children with ASD and conduct long-term follow-up during their early childhood to promote early diagnosis and develop personalized intervention plans. TRIAL REGISTRATION ChiCTR2000031194 , registered on 03/23/2020.
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Affiliation(s)
- Qian Zhang
- grid.488412.3Department of Child Health Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014 China
| | - Qiu Li
- grid.488412.3Department of Child Health Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014 China
| | - Ting Yang
- grid.488412.3Department of Child Health Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014 China
| | - Li Chen
- grid.488412.3Department of Child Health Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014 China
| | - Ying Dai
- grid.488412.3Department of Child Health Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014 China
| | - Hua Wei
- grid.488412.3Department of Child Health Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014 China
| | - Ke Wang
- grid.488412.3Children’s Medical Big Data Intelligent Application Chongqing University Engineering Research Center, Children’s Hospital of Chongqing Medical University, Chongqing, 400014 China
| | - Feiyong Jia
- grid.430605.40000 0004 1758 4110Department of Developmental and Behavioral Pediatric, The First Hospital of Jilin University, Changchun, 130021 China
| | - Lijie Wu
- grid.410736.70000 0001 2204 9268Department of Children’s and Adolescent Health, Public Health College of Harbin Medical University, Harbin, 150081 China
| | - Yan Hao
- grid.33199.310000 0004 0368 7223Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Ling Li
- grid.502812.cDepartment of Children Rehabilitation, Hainan Women and Children’s Medical Center, Haikou, 570100 China
| | - Jie Zhang
- grid.452902.8Xi’an Children’s Hospital, Xi’an, 710003 China
| | - Xiaoyan Ke
- grid.452645.40000 0004 1798 8369Child Mental Health Research Center of Nanjing Brain Hospital, Nanjing, 210013 China
| | - Mingji Yi
- grid.412521.10000 0004 1769 1119Department of Child Health Care, The Affiliated Hospital of Qingdao University, Qingdao, 266003 China
| | - Qi Hong
- Maternal and Child Health Hospital of Baoan, Shenzhen, 518133 China
| | - Jinjin Chen
- grid.16821.3c0000 0004 0368 8293Department of Child Healthcare, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, 200040 China
| | - Shuanfeng Fang
- grid.207374.50000 0001 2189 3846Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, 450053 China
| | - Yichao Wang
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008 China
| | - Qi Wang
- Deyang Maternity & Child Healthcare Hospital, Deyang, 618000 Sichuan China
| | - Chunhua Jin
- grid.418633.b0000 0004 1771 7032Department of Children Health Care, Capital Institute of Pediatrics, Beijing, 100020 China
| | - Jie Chen
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014, China.
| | - Tingyu Li
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, 400014, China.
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31
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Bhat AN, Boulton AJ, Tulsky DS. A further study of relations between motor impairment and social communication, cognitive, language, functional impairments, and repetitive behavior severity in children with ASD using the SPARK study dataset. Autism Res 2022; 15:1156-1178. [PMID: 35357764 DOI: 10.1002/aur.2711] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/17/2022] [Accepted: 03/07/2022] [Indexed: 12/11/2022]
Abstract
Motor impairments are pervasive and persistent in children with autism spectrum disorder (ASD) throughout childhood and adolescence. Based on recent studies examining motor impairments in children with ASD between 5 and 15 years (i.e., SPARK study sample), 87-88% of this population is at-risk for a motor impairment, these problems persisted until 15 years, and related to their core (social communication skills and repetitive behaviors [RBs]) and comorbid (language, cognitive, and functional) impairments. Persistent motor impairments extending into adolescence/adulthood could negatively impact their independent daily living skills, physical fitness/activity levels, and physical/mental health. While multiple studies have examined relations between motor dimensions and core/comorbid impairments in young children with ASD, few studies have examined such relations in school-age children/adolescents with ASD. This paper conducts a further multidimensional study of which motor domains (i.e., gross-motor including visuo-motor or multilimb coordination/planning, fine motor [FM] or general coordination [GC] skills) best distinguish subgroups of school-age children/adolescents with ASD and help predict core and comorbid impairments after accounting for age and sex. Visuomotor, FM and certain GC skills were better at explaining variations in/predicting social communication impairments whereas FM skills were slightly better at explaining variations in/predicting RB severity. Multilimb coordination/planning and FM skills explained variations in/predicted cognitive delays whereas visuomotor and FM skills explained variations in and better predicted language delays. All three motor dimensions explained variations in/predicted functional delays. This study provides further evidence for inclusion of motor impairments within the ASD definition (criteria or specifiers). LAY SUMMARY: Gross-motor skills were related to social communication and functional delays of children with ASD (visuomotor skills related to language delays and multilimb coordination/planning skills related to cognitive delays). Fine-motor skills were related to repetitive behavior severity, language, cognitive, and functional delays in ASD. Diagnosticians should recommend systematic motor screening, further evaluations, and treatments for children at-risk for and diagnosed with ASD. Motor advocacy and enhanced public/clinical community awareness is needed to fulfill the unmet motor needs of children with ASD.
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Affiliation(s)
- Anjana N Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Aaron J Boulton
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA.,Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
| | - David S Tulsky
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.,Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, USA.,Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware, USA
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Faraji S, Najafabadi MG, Zandi HG, Parent-Nichols J. Water-Based Exercise Therapy And Improvement In The Motor Skills And Cognitive Function Of Children With Autism Spectrum Disorder: A Commentary. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background — Motor and cognitive dysfunction are common impairments experienced by children with a diagnosis of autism spectrum disorder (ASD). Objective: The main aim of this study was to present suggestions for the incorporation of water-based exercises in rehabilitation for the children with ASD. Methods — Researchers collected the current available data regarding novel methods of water-based exercise therapy for the children with ASD to address motor and cognitive function. Results — Children with a diagnosis of ASD face a number of common challenges that may be addressed by the utilization of aquatic therapy in their rehabilitation plan. Challenges commonly experienced by children with ASD may be addressed by properties of water and aquatic therapies. Presently, aquatic therapy is an underutilized resource as an intervention in the population of children with ASD. Conclusions — Water-based interventions is currently underutilized as a therapeutic intervention should be considered for individuals with a diagnosis of ASD.
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Rincón-Rufo D, Vera-Pérez V, Cuesta-Gómez A, Carratalá-Tejada M. Prediction of Communicative Disorders Linked to Autistic Spectrum Disorder Based on Early Psychomotor Analysis. CHILDREN (BASEL, SWITZERLAND) 2022; 9:397. [PMID: 35327769 PMCID: PMC8947747 DOI: 10.3390/children9030397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
This systematic review evaluated psychomotor differences between children with and without siblings who have autism spectrum disorder (ASD), as well as the most reliable psychomotor skills that can help predict ASD and its associated language disorders. Literature from 2005 to 2020 was searched using the following databases: PubMed, Trip Medical Database, Cochrane, Web of Science, Science Direct, and Brain. A total 11 papers were included. Fine motor skills and joint attention displayed reliable results in order to predict ASD and its associated language disorders. The period between the first and the second year of life was considered the most appropriate one for the assessment of psychomotor skills. The best period to predict language disorders and ASD diagnosis is around 36 months old.
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Affiliation(s)
| | | | - Alicia Cuesta-Gómez
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Alcorcón, Spain;
| | - María Carratalá-Tejada
- Motion Analysis, Ergonomics, Biomechanics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Alcorcón, Spain;
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Effects of Square-Stepping Exercise on Motor and Cognitive Skills in Autism Spectrum Disorder Children and Adolescents: A Study Protocol. Healthcare (Basel) 2022; 10:healthcare10030450. [PMID: 35326928 PMCID: PMC8950471 DOI: 10.3390/healthcare10030450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/13/2022] [Accepted: 02/24/2022] [Indexed: 01/25/2023] Open
Abstract
Individuals with autism spectrum disorder (ASD) diagnoses present not only cognitive, emotional, communicative, and social challenges but also movement issues that affect their everyday activities, learning, and leisure. The use of the square-stepping exercise (SSE), a motor program initially created to strengthen the lower limbs of older adults, is spreading because of its advantages (e.g., balance and lower limb strength improvements). A study protocol to assess the SSE effects on motor, sensory, and cognitive skills in Spanish children and adolescents between 6 and 12 years old with ASD diagnoses is presented. A randomised clinical will be performed, recruiting 52 children and adolescents with ASD who will be distributed into two groups: an experimental (n = 26) and a control (n = 26) group. The SSE sessions will be held for 9 weeks (two times per week). The main variable will be balance, which will be measured with the Movement Assessment Battery for Children 2 (MABC2), and secondary outcomes will include sensory processing, attention, and executive functions. Assessments will be carried out before and at the end of the program implementation, including an additional follow up one month later. If this program obtains positive results, it should be implemented in different settings (schools, clinics, associations, etc.) to improve the quality of movement and development in children and adolescents with ASD, as it is an easy-to-use and structured tool.
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Posar A, Visconti P. Early Motor Signs in Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020294. [PMID: 35205014 PMCID: PMC8870370 DOI: 10.3390/children9020294] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022]
Abstract
A growing number of literature data suggest the presence of early impairments in the motor development of children with autism spectrum disorder, which could be often recognized even before the appearance of the classical social communication deficits of autism. In this narrative review, we aimed at performing an update about the available data on the early motor function in children with autism spectrum disorder. Early motor impairment in these children can manifest itself both as a mere delay of motor development and as the presence of atypicalities of motor function, such as a higher rate and a larger inventory, of stereotyped movements both with and without objects. In the perspective of a timely diagnosis, the presence of early motor signs can be an important clue, especially in an individual considered at high risk for autism. Motor and communication (both verbal and non-verbal) skills are connected and a pathogenetic role of early motor dysfunctions in the development of autism can be hypothesized. From this, derives the importance of an early enabling intervention aimed at improving motor skills, which could also have favorable effects on other aspects of development.
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Affiliation(s)
- Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, 40139 Bologna, Italy;
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, 40126 Bologna, Italy
- Correspondence: ; Tel.: +39-051-6225111
| | - Paola Visconti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, 40139 Bologna, Italy;
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36
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Zhang M, Huang Y, Jiao J, Yuan D, Hu X, Yang P, Zhang R, Wen L, Situ M, Cai J, Sun X, Guo K, Huang X, Huang Y. Transdiagnostic symptom subtypes across autism spectrum disorders and attention deficit hyperactivity disorder: validated by measures of neurocognition and structural connectivity. BMC Psychiatry 2022; 22:102. [PMID: 35139813 PMCID: PMC8827180 DOI: 10.1186/s12888-022-03734-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUNDS Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders that exhibit within-disorder heterogeneity and cross-disorder phenotypic overlap, thus suggesting that the current disease categories may not fully represent the etiologic essence of the disorders, especially for highly comorbid neurodevelopmental disorders. In this study, we explored the subtypes of a combined sample of ASD and ADHD by integrating measurements of behavior, cognition and brain imaging. METHODS A total of 164 participants, including 65 with ASD, 47 with ADHD, and 52 controls, were recruited. Unsupervised machine learning with an agglomerative hierarchical clustering algorithm was used to identify transdiagnostic symptom clusters. Neurocognition and brain structural connectivity measurements were used to assess symptom clusters. Mediation analysis was used to explore the relationship between transdiagnostic symptoms, neurocognition and brain structural connectivity. RESULTS We identified three symptom clusters that did not fall within the diagnostic boundaries of DSM. External measurements from neurocognition and neuroimaging domains supported distinct profiles, including fine motor function, verbal fluency, and structural connectivity in the corpus callosum between these symptom clusters, highlighting possible biomarkers for ASD and ADHD. Additionally, fine motor function was shown to mediate the relationship between the corpus callosum and perseveration symptoms. CONCLUSIONS In this transdiagnostic study on ASD and ADHD, we identified three subtypes showing meaningful associations between symptoms, neurocognition and brain white matter structural connectivity. The fine motor function and structural connectivity of corpus callosum might be used as biomarkers for neurodevelopmental disorders with social skill symptoms. The results of this study highlighted the importance of precise phenotyping and further supported the effects of fine motor intervention on ASD and ADHD.
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Affiliation(s)
- Manxue Zhang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Huang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jian Jiao
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Danfeng Yuan
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiao Hu
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Pingyuan Yang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Rui Zhang
- grid.54549.390000 0004 0369 4060University of Electronic Science and Technology of China, Chengdu, China
| | - Liangjian Wen
- grid.54549.390000 0004 0369 4060University of Electronic Science and Technology of China, Chengdu, China
| | - Mingjing Situ
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jia Cai
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xueli Sun
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Kuifang Guo
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xia Huang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China. .,Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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37
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Affiliation(s)
- Annio Posar
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italia
| | - Paola Visconti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Disturbi dello Spettro Autistico, Bologna, Italia; Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
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38
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Djordjević M, Memisevic H, Potic S, Djuric U. Exercise-Based Interventions Aimed at Improving Balance in Children with Autism Spectrum Disorder: A Meta-Analysis. Percept Mot Skills 2021; 129:90-119. [PMID: 34936828 DOI: 10.1177/00315125211060231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Children with Autism Spectrum Disorder (ASD) often have deficits in motor skills, especially balance. This article presents a meta-analytic review of 15 intervention studies that aimed to improve balance in children and adolescents with ASD. Across these studies, there were 195 participants with ASD for whom pre-intervention and post-intervention balance scores were available. We measured the standardized mean difference (Hedges' g) between their pre-intervention and post-intervention balance scores and found a large, positive effect from these balance interventions (standardized mean difference-1.82 (95% CI [1.34, 2.29])). Various balance intervention procedures were shown to be very efficacious for children and adolescents with ASD. Clearly, balance is a motor skill that is very susceptible to intervention efforts. We also provided recommendations to researchers regarding what information to include when conducting intervention studies.
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Affiliation(s)
- Mirjana Djordjević
- Faculty of Special Education and Rehabilitation, 54801University of Belgrade, Beograd, Serbia
| | - Haris Memisevic
- Faculty of Educational Sciences, 112354University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Srecko Potic
- High Medical College for Professional Studies "Milutin Milanković", Belgrade, Serbia
| | - Uros Djuric
- Faculty of Special Education and Rehabilitation, 54801University of Belgrade, Beograd, Serbia
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39
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Geng L, Yang Y. Retrospective study of Rougan Tongdu Tuina combined with point-pressing massage therapy on neurodevelopment in children with delayed motor development at very early stage. Transl Pediatr 2021; 10:3202-3210. [PMID: 35070834 PMCID: PMC8753475 DOI: 10.21037/tp-21-558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Particular factors before and after delivery can cause neurological damage to the fetus or newborn. Rougan Tongdu Tuina combined with point-pressing massage therapy (RTPM) can effectively stimulate the meridians and acupoints, and achieve the therapeutic effects of refreshing, resuscitating, and strengthening the brain and improving cognition. In this study, RTPM was used in the neonatal period, and quality evaluation results of general movements (GMs) were used to monitor the effect of this method on neurodevelopmental outcomes of children. METHODS Children who were born in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from 1 March 2017 to 29 February 2020 were retrospectively enrolled. All newborns were assessed for the quality of GMs. Children in the RTPM group received RTPM, and the control group received conventional massage and point-pressing. A 20-day period constituted a round of treatment, each round was 20 days apart, and there were 3 rounds in total. The study participants received regular outpatient follow-ups, and clinical neurological examinations and Gesell development scales (GDS) assessment results were used to determine the outcome of motor development. RESULTS A total of 96 newborns with abnormal GMs were retrospectively included, including 57 (59.4%) males and 39 (40.6%) females. There were 83 cases (86.5%) of premature infants and 85 cases (88.5%) of low birthweight infants, respectively. The Apgar score at 1 min after birth was rated 3-10 points, with an average of 7.4 points. The evaluation of GMs revealed that the indicators in the RTPM group were significantly better than those in the control group, and the number of children with abnormal GMs after each round of treatment was significantly reduced compared with the control group. At 6 months, the GDS score of the RTPM group was better than that in the control group. After the intervention, the total effective rate of the RTPM group was 92.2%, which was significantly higher than the 75.6% of the control group (P<0.05). CONCLUSIONS The application of RTPM in the neonatal period can significantly improve the neurodevelopment of children.
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Affiliation(s)
- Limei Geng
- Department of Neonatology, The First Affiliated Hospital of Guizhou University of Chinese Traditional Medicine, Guiyang, China
| | - Yang Yang
- Department of Neonatology, The First Affiliated Hospital of Guizhou University of Chinese Traditional Medicine, Guiyang, China
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40
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Patterson JW, Armstrong V, Duku E, Richard A, Franchini M, Brian J, Zwaigenbaum L, Bryson SE, Sacrey LAR, Roncadin C, Smith IM. Early trajectories of motor skills in infant siblings of children with autism spectrum disorder. Autism Res 2021; 15:481-492. [PMID: 34826349 DOI: 10.1002/aur.2641] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/12/2021] [Accepted: 11/06/2021] [Indexed: 11/06/2022]
Abstract
Delays in motor development are not considered a core feature of autism spectrum disorder (ASD). Yet, recent studies of infant siblings of children with ASD suggest that early delays in motor skills may be associated with later delays in developmental areas considered to be core features of an ASD diagnosis. While these studies demonstrate the longitudinal association between core features and motor delays observed at single time points, there is considerable interest in studying the trajectories of motor development over the first 3 years of life. To accomplish this, we investigated early trajectories of motor development in a cohort of 499 infant siblings of children with ASD and 176 children with no family history of ASD. Data for the current study were drawn from the prospective, multi-site, Canadian Infant Sibling Study. We evaluated trajectories of fine and gross motor development over the first 3 years using group-based trajectory modeling. Our results show that membership for both fine and gross motor trajectory groups was related to expressive language skills, receptive language skills, ASD symptom severity scores, and diagnostic classification at age 3. These results provide evidence that the trajectory of a child's early motor development may have important prognostic implications in ASD.
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Affiliation(s)
| | | | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Annie Richard
- Autism Research Centre, IWK Health Centre, Halifax, Canada
| | | | - Jessica Brian
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Autism Research Center, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Susan E Bryson
- Department of Pediatrics, Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lori-Ann R Sacrey
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Autism Research Center, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Caroline Roncadin
- McMaster Children's Hospital Autism Program, Hamilton, Ontario, Canada
| | - Isabel M Smith
- Autism Research Centre, IWK Health Centre, Halifax, Canada.,Department of Pediatrics, Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
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41
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de Mendonça Filho EJ, Barth B, Bandeira DR, de Lima RMS, Arcego DM, Dalmaz C, Pokhvisneva I, Sassi RB, Hall GBC, Meaney MJ, Silveira PP. Cognitive Development and Brain Gray Matter Susceptibility to Prenatal Adversities: Moderation by the Prefrontal Cortex Brain-Derived Neurotrophic Factor Gene Co-expression Network. Front Neurosci 2021; 15:744743. [PMID: 34899157 PMCID: PMC8652300 DOI: 10.3389/fnins.2021.744743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Previous studies focused on the relationship between prenatal conditions and neurodevelopmental outcomes later in life, but few have explored the interplay between gene co-expression networks and prenatal adversity conditions on cognitive development trajectories and gray matter density. Methods: We analyzed the moderation effects of an expression polygenic score (ePRS) for the Brain-derived Neurotrophic Factor gene network (BDNF ePRS) on the association between prenatal adversity and child cognitive development. A score based on genes co-expressed with the prefrontal cortex (PFC) BDNF was created, using the effect size of the association between the individual single nucleotide polymorphisms (SNP) and the BDNF expression in the PFC. Cognitive development trajectories of 157 young children from the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) cohort were assessed longitudinally in 4-time points (6, 12, 18, and 36 months) using the Bayley-II mental scales. Results: Linear mixed-effects modeling indicated that BDNF ePRS moderates the effects of prenatal adversity on cognitive growth. In children with high BDNF ePRS, higher prenatal adversity was associated with slower cognitive development in comparison with those exposed to lower prenatal adversity. Parallel-Independent Component Analysis (pICA) suggested that associations of expression-based SNPs and gray matter density significantly differed between low and high prenatal adversity groups. The brain IC included areas involved in visual association processes (Brodmann area 19 and 18), reallocation of attention, and integration of information across the supramodal cortex (Brodmann area 10). Conclusion: Cognitive development trajectories and brain gray matter seem to be influenced by the interplay of prenatal environmental conditions and the expression of an important BDNF gene network that guides the growth and plasticity of neurons and synapses.
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Affiliation(s)
- Euclides José de Mendonça Filho
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
| | - Barbara Barth
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Denise Ruschel Bandeira
- Programa de Pós-Graduação em Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Randriely Merscher Sobreira de Lima
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Programa de Pós-Graduação em Bioquímica e Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Danusa Mar Arcego
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
| | - Carla Dalmaz
- Programa de Pós-Graduação em Bioquímica e Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
| | | | - Geoffrey B. C. Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Michael J. Meaney
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Patricia Pelufo Silveira
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
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42
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Serra I, Manusama OR, Kaiser FMP, Floriano II, Wahl L, van der Zalm C, IJspeert H, van Hagen PM, van Beveren NJM, Arend SM, Okkenhaug K, Pel JJM, Dalm VASH, Badura A. Activated PI3Kδ syndrome, an immunodeficiency disorder, leads to sensorimotor deficits recapitulated in a murine model. Brain Behav Immun Health 2021; 18:100377. [PMID: 34786564 PMCID: PMC8579111 DOI: 10.1016/j.bbih.2021.100377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/24/2021] [Accepted: 10/18/2021] [Indexed: 02/08/2023] Open
Abstract
The phosphoinositide-3-kinase (PI3K) family plays a major role in cell signaling and is predominant in leukocytes. Gain-of-function (GOF) mutations in the PIK3CD gene lead to the development of activated PI3Kδ syndrome (APDS), a rare primary immunodeficiency disorder. A subset of APDS patients also displays neurodevelopmental delay symptoms, suggesting a potential role of PIK3CD in cognitive and behavioural function. However, the extent and nature of the neurodevelopmental deficits has not been previously quantified. Here, we assessed the cognitive functions of two APDS patients, and investigated the causal role of the PIK3CD GOF mutation in neurological deficits using a murine model of this disease. We used p110δE1020K knock-in mice, harbouring the most common APDS mutation in patients. We found that APDS patients present with visuomotor deficits, exacerbated by autism spectrum disorder comorbidity, whereas p110δE1020K mice exhibited impairments in motor behaviour, learning and repetitive behaviour patterning. Our data indicate that PIK3CD GOF mutations increase the risk for neurodevelopmental deficits, supporting previous findings on the interplay between the nervous and the immune system. Further, our results validate the knock-in mouse model, and offer an objective assessment tool for patients that could be incorporated in diagnosis and in the evaluation of treatments.
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Affiliation(s)
- Ines Serra
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| | | | - Fabian M P Kaiser
- Department of Immunology, Erasmus MC, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, Rotterdam, the Netherlands
| | | | - Lucas Wahl
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| | | | - Hanna IJspeert
- Department of Immunology, Erasmus MC, Rotterdam, the Netherlands
| | - P Martin van Hagen
- Department of Immunology, Erasmus MC, Rotterdam, the Netherlands.,Division of Clinical Immunology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
| | | | - Sandra M Arend
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Klaus Okkenhaug
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Johan J M Pel
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Virgil A S H Dalm
- Department of Immunology, Erasmus MC, Rotterdam, the Netherlands.,Division of Clinical Immunology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands.,Academic Center for Rare Immunological Diseases (RIDC), Erasmus MC, Rotterdam, the Netherlands
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43
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Zampella CJ, Wang LAL, Haley M, Hutchinson AG, de Marchena A. Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review. Curr Psychiatry Rep 2021; 23:64. [PMID: 34387753 DOI: 10.1007/s11920-021-01280-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW This review synthesizes recent, clinically relevant findings on the scope, significance, and centrality of motor skill differences in autism spectrum disorder (ASD). RECENT FINDINGS Motor challenges in ASD are pervasive, clinically meaningful, and highly underrecognized, with up to 87% of the autistic population affected but only a small percentage receiving motor-focused clinical care. Across development, motor differences are associated with both core autism symptoms and broader functioning, though the precise nature of those associations and the specificity of motor profiles to ASD remain unestablished. Findings suggest that motor difficulties in ASD are quantifiable and treatable, and that detection and intervention efforts targeting motor function may also positively influence social communication. Recent evidence supports a need for explicit recognition of motor impairment within the diagnostic framework of ASD as a clinical specifier. Motor differences in ASD warrant greater clinical attention and routine incorporation into screening, evaluation, and treatment planning.
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Affiliation(s)
- Casey J Zampella
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Leah A L Wang
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Margaret Haley
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anne G Hutchinson
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ashley de Marchena
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, USA
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44
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Taverna EC, Huedo-Medina TB, Fein DA, Eigsti IM. The interaction of fine motor, gesture, and structural language skills: The case of autism spectrum disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2021; 86:101824. [PMID: 34306180 PMCID: PMC8294070 DOI: 10.1016/j.rasd.2021.101824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Motor skill differences have been consistently reported in individuals with ASD. Associations between motor skill and social communication skills have been reported in both typical development (TD) and autism spectrum disorder (ASD). The current study extends these findings to characterize performance on a fine motor imitation task, probing skills as a predictor of social and communicative functioning, and co-speech gesture use. These research questions were addressed by a secondary analysis of data collected during a previous study characterizing a cohort of individuals who were diagnosed with ASD in early childhood but lost the autism diagnosis (LAD) by the time of adolescence. Fine motor imitation skills were compared between 14 individuals with LAD, 15 individuals with autism spectrum disorder (ASD), and 12 typically developing (TD) individuals. LAD and TD groups had more advanced fine motor imitation skills than the ASD group, and abilities were significantly associated with ASD symptoms and amount of gesture use (though there was a counterintuitive interaction between group and fine motor skill in the LAD and TD groups only, in which lower motor skills predicted more ASD symptoms; this relationship was of a small effect size and is likely driven by the compressed range of fine motor skills in these two groups). Findings suggest that fine motor skills normalize along with social communication skills and restricted and repetitive behaviors and interests in individuals who lose the ASD diagnosis, and that individuals with better fine motor abilities produce more co-speech gesture.
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Affiliation(s)
- Elise C. Taverna
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
| | - Tania B. Huedo-Medina
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
| | - Deborah A. Fein
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
| | - Inge-Marie Eigsti
- University of Connecticut Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06260, United States
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45
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Chenausky KV, Brignell A, Morgan AT, Norton AC, Tager-Flusberg HB, Schlaug G, Guenther FH. A Modeling-Guided Case Study of Disordered Speech in Minimally Verbal Children With Autism Spectrum Disorder. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1542-1557. [PMID: 33852328 PMCID: PMC8702870 DOI: 10.1044/2021_ajslp-20-00121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/14/2020] [Accepted: 01/08/2021] [Indexed: 06/03/2023]
Abstract
Purpose Understanding what limits speech development in minimally verbal (MV) children with autism spectrum disorder (ASD) is important for providing highly effective targeted therapies. This preliminary investigation explores the extent to which developmental speech deficits predicted by Directions Into Velocities of Articulators (DIVA), a computational model of speech production, exemplify real phenotypes. Method Implementing a motor speech disorder in DIVA predicted that speech would become highly variable within and between tokens, while implementing a motor speech plus an auditory processing disorder predicted that DIVA's speech would become highly centralized (schwa-like). Acoustic analyses of DIVA's output predicted that acoustically measured phoneme distortion would be similar between the two cases, but that in the former case, speech would show more within- and between-token variability than in the latter case. We tested these predictions quantitatively on the speech of children with MV ASD. In Study 1, we tested the qualitative predictions using perceptual analysis methods. Speech pathologists blinded to the purpose of the study tallied the signs of childhood apraxia of speech that appeared in the speech of 38 MV children with ASD. K-means clustering was used to create two clusters from the group of 38, and analysis of variance was used to determine whether the clusters differed according to perceptual features corresponding to within- and between-token variability. In Study 2, we employed acoustic analyses on the speech of the child from each cluster who produced the largest number of analyzable tokens to test the predictions of differences in within-token variability, between-token variability, and vowel space area. Results Clusters produced by k-means analysis differed by perceptual features that corresponded to within-token variability. Nonsignificant differences between clusters were found for features corresponding to between-token variability. Subsequent acoustic analyses of the selected cases revealed that the speech of the child from the high-variability cluster showed significantly more quantitative within- and between-token variability than the speech of the child from the low-variability cluster. The vowel space of the child from the low-variability cluster was more centralized than that of typical children and that of the child from the high-variability cluster. Conclusions Results provide preliminary evidence that subphenotypes of children with MV ASD may exist, characterized by (a) comorbid motor speech disorder and (b) comorbid motor speech plus auditory processing disorder. The results motivate testable predictions about how these comorbidities affect speech. Supplemental Material https://doi.org/10.23641/asha.14384432.
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Affiliation(s)
- Karen V. Chenausky
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
| | - Amanda Brignell
- Speech and Language, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- University of Melbourne, Victoria, Australia
| | - Angela T. Morgan
- Speech and Language, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Andrea C. Norton
- Music, Neuroimaging, and Stroke Recovery Laboratory, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Gottfried Schlaug
- Harvard Medical School, Boston, MA
- Music, Neuroimaging, and Stroke Recovery Laboratory, Beth Israel Deaconess Medical Center, Boston, MA
- Brain Repair and Neurorestoration Center, Baystate Medical Center, Springfield, MA
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Sasayama D, Kudo T, Kaneko W, Kuge R, Koizumi N, Nomiyama T, Washizuka S, Honda H. Brief Report: Cumulative Incidence of Autism Spectrum Disorder Before School Entry in a Thoroughly Screened Population. J Autism Dev Disord 2021; 51:1400-1405. [PMID: 32696286 DOI: 10.1007/s10803-020-04619-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The present study aimed to identify the cumulative incidence of autism spectrum disorder (ASD) in a thoroughly screened population and to examine the behavioral and motor characteristics observed in children with ASD at the age of 18 months. Subjects were 1067 children who underwent a screening assessment for ASD at the routine 18-months health checkup. By the age of 6 years, 3.1% (4.3% of boys and 2.0% of girls) were diagnosed as having ASD by their attending pediatricians. Higher rate of difficulties in motor skills and social and communication skills had been reported in children with ASD at 18 months of age. This study showed that careful community-based screening system may be helpful in detecting ASD at early age.
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Affiliation(s)
- Daimei Sasayama
- Department of Psychiatry, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Nagano, 390-8621, Japan.
- Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan.
- Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, 390-8621, Japan.
| | - Tetsuya Kudo
- Shinano Medical Welfare Center, Shimo-Suwa, Nagano, 393-0093, Japan
| | - Wakako Kaneko
- Shinano Medical Welfare Center, Shimo-Suwa, Nagano, 393-0093, Japan
| | - Rie Kuge
- Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan
- Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, 390-8621, Japan
| | - Noriaki Koizumi
- Center for Mental Health and Welfare of Nagano Prefecture, NaganoNagano, Nagano, 380-0928, Japan
| | - Tetsuo Nomiyama
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, Matsumoto, Nagano, 390-8621, Japan
| | - Shinsuke Washizuka
- Department of Psychiatry, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Hideo Honda
- Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan
- Mental Health Clinic for Children, Shinshu University Hospital, Matsumoto, Nagano, 390-8621, Japan
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Licari MK, Varcin K, Hudry K, Leonard HC, Alvares GA, Pillar SV, Stevenson PG, Cooper MN, Whitehouse AJO. The course and prognostic capability of motor difficulties in infants showing early signs of autism. Autism Res 2021; 14:1759-1768. [PMID: 34021977 DOI: 10.1002/aur.2545] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 11/12/2022]
Abstract
Delays within the motor domain are often overlooked as an early surveillance marker for autism. The present study evaluated motor difficulties and its potential as an early predictive marker for later autism likelihood in a cohort of infants (N = 96) showing early behavioral signs of autism aged 9-14 months. The motor domain was evaluated using the motor subscales of the Mullen Scales of Early Learning at baseline, and at a 6-month follow-up. The Autism Diagnostic Observation Schedule - Toddler Module (ADOS-T) was completed at follow-up as a measure of autism likelihood. Motor difficulties were common at baseline, with 63/96 (65.6%) infants scoring very low or below average in the gross motor domain and 29/96 (30.2%) in the fine motor domain. At follow-up, gross motor difficulties had resolved for many, with 23/63 (36.5%) infants maintaining these difficulties. Fine motor difficulties resolved in fewer infants, with 20/29 (69.0%) continuing to present with fine motor delays at follow-up. Adjusted linear regression models suggested that fine motor scores at baseline (β = -0.12, SE = 0.04) and follow-up (β = -0.17, SE = 0.05) were associated with higher ADOS-T scores; with difficulties across both timepoints (β = 5.60, SE = 1.35) the strongest (largest in magnitude) association with ADOS-T scores of the predictors examined. Motor difficulties are prominent in children displaying emerging signs of autism, with persistent fine motor difficulties predictive of the developing autism phenotype. The findings indicate the potential clinical value of including evaluation of motor skills within early autism surveillance measures. LAY SUMMARY: This prospective study evaluated motor development over a 6-month period in infants showing early behavioral signs of autism. Atypical motor development was a common feature of infants showing early signs of autism and persistent fine motor difficulties were predictive of the emerging autism phenotype.
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Affiliation(s)
- Melissa K Licari
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Kandice Varcin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Kristelle Hudry
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | | | - Gail A Alvares
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Sarah V Pillar
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Paul G Stevenson
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew N Cooper
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew J O Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
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48
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Canu D, Van der Paelt S, Canal-Bedia R, Posada M, Vanvuchelen M, Roeyers H. Early non-social behavioural indicators of autism spectrum disorder (ASD) in siblings at elevated likelihood for ASD: a systematic review. Eur Child Adolesc Psychiatry 2021; 30:497-538. [PMID: 32088859 PMCID: PMC8041710 DOI: 10.1007/s00787-020-01487-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/31/2020] [Indexed: 12/19/2022]
Abstract
We aimed at identifying early non-social behavioural indicators that predict later ASD. Likewise, we were interested in the moment in which non-social signs discriminate between children at elevated likelihood for ASD with a later diagnosis of ASD, and children at elevated likelihood for ASD with a typical developmental outcome. In addition, we intended to explore the developmental evolution of children's symptomatology over time. A systematic literature search was conducted for longitudinal studies on early non-social behavioural indicators among siblings at elevated likelihood for ASD. The following databases were searched: PUBMED, Web of Science, PsycINFO, CINAHL and EMBASE. The study identification process was conducted by two reviewers independently. Compared to siblings at elevated likelihood for ASD with a typical developmental outcome, siblings at elevated likelihood for ASD with later ASD show impairments in attention disengagement, in gross and fine motor development and characteristic restricted and repetitive interests and behaviours, starting at 12 months of age. Moreover, early attention disengagement exerts a predictive role towards a later ASD diagnosis, given that from 12 months siblings at elevated likelihood for ASD who will receive an independent ASD diagnosis towards 24-36 months present marked difficulties in disengaging in comparison with siblings at elevated likelihood for ASD that will not satisfy the criteria for an ASD diagnosis. The findings call for a more comprehensive vision on early indicators of ASD. Further research is needed to extend results to other behavioural domains.
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Affiliation(s)
- Daniela Canu
- Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL), Hasselt Unversity, Agoralaan, Building A, 3590 Diepenbeek, Hasselt, Belgium.
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Sara Van der Paelt
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ricardo Canal-Bedia
- Instituto Universitario de Integración en la Comunidad (INICO), University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Institute of Rare Diseases Research & CIBERER, Instituto de Salud Carlos III, Madrid, Spain
| | - Marleen Vanvuchelen
- Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL), Hasselt Unversity, Agoralaan, Building A, 3590 Diepenbeek, Hasselt, Belgium
| | - Herbert Roeyers
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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49
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Tanner A, Dounavi K. The Emergence of Autism Symptoms Prior to 18 Months of Age: A Systematic Literature Review. J Autism Dev Disord 2021; 51:973-993. [PMID: 32734422 DOI: 10.1007/s10803-020-04618-w/tables/3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Pre-diagnostic intervention for autism spectrum disorder (ASD) allows symptoms to be addressed as they emerge, often between six to 18 months, rather than after the full onset of the disorder. A systematic literature review, spanning the previous six years was conducted in order to provide an updated review looking at the earliest behavior symptoms of ASD. All included studies used a prospective experimental design, reported on symptoms that emerged before 18-months of age, exclusively in children who would later receive a diagnosis, and were assessed for quality. This review is the first to address this research question through the use of a systematic research design and extends the literature by following up on recommendations for future research from previous findings.
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Affiliation(s)
- Amy Tanner
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| | - Katerina Dounavi
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
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50
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Tanner A, Dounavi K. The Emergence of Autism Symptoms Prior to 18 Months of Age: A Systematic Literature Review. J Autism Dev Disord 2021; 51:973-993. [PMID: 32734422 PMCID: PMC7954747 DOI: 10.1007/s10803-020-04618-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pre-diagnostic intervention for autism spectrum disorder (ASD) allows symptoms to be addressed as they emerge, often between six to 18 months, rather than after the full onset of the disorder. A systematic literature review, spanning the previous six years was conducted in order to provide an updated review looking at the earliest behavior symptoms of ASD. All included studies used a prospective experimental design, reported on symptoms that emerged before 18-months of age, exclusively in children who would later receive a diagnosis, and were assessed for quality. This review is the first to address this research question through the use of a systematic research design and extends the literature by following up on recommendations for future research from previous findings.
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Affiliation(s)
- Amy Tanner
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
| | - Katerina Dounavi
- Queen's University of Belfast, Belfast, Northern Ireland.
- School of Social Sciences, Education & Social Work, 69-71 University Street, Belfast, BT7 1HL, Northern Ireland.
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