1
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Mullin LJ, Rutsohn J, Gross JL, Caravella KE, Grzadzinski RL, Weisenfeld LA, Flake L, Botteron KN, Dager SR, Estes AM, Pandey J, Schultz RT, St John T, Wolff JJ, Shen MD, Piven J, Hazlett HC, Girault JB. Differential cognitive and behavioral development from 6 to 24 months in autism and fragile X syndrome. J Neurodev Disord 2024; 16:12. [PMID: 38509470 PMCID: PMC10953146 DOI: 10.1186/s11689-024-09519-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Specifying early developmental differences among neurodevelopmental disorders with distinct etiologies is critical to improving early identification and tailored intervention during the first years of life. Recent studies have uncovered important differences between infants with fragile X syndrome (FXS) and infants with familial history of autism spectrum disorder who go on to develop autism themselves (FH-ASD), including differences in brain development and behavior. Thus far, there have been no studies longitudinally investigating differential developmental skill profiles in FXS and FH-ASD infants. METHODS The current study contrasted longitudinal trajectories of verbal (expressive and receptive language) and nonverbal (gross and fine motor, visual reception) skills in FXS and FH-ASD infants, compared to FH infants who did not develop ASD (FH-nonASD) and typically developing controls. RESULTS Infants with FXS showed delays on a nonverbal composite compared to FH-ASD (as well as FH-nonASD and control) infants as early as 6 months of age. By 12 months an ordinal pattern of scores was established between groups on all domains tested, such that controls > FH-nonASD > FH-ASD > FXS. This pattern persisted through 24 months. Cognitive level differentially influenced developmental trajectories for FXS and FH-ASD. CONCLUSIONS Our results demonstrate detectable group differences by 6 months between FXS and FH-ASD as well as differential trajectories on each domain throughout infancy. This work further highlights an earlier onset of global cognitive delays in FXS and, conversely, a protracted period of more slowly emerging delays in FH-ASD. Divergent neural and cognitive development in infancy between FXS and FH-ASD contributes to our understanding of important distinctions in the development and behavioral phenotype of these two groups.
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Affiliation(s)
- Lindsay J Mullin
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Joshua Rutsohn
- Department of Biostatistics, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Julia L Gross
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Kelly E Caravella
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Rebecca L Grzadzinski
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Leigh Anne Weisenfeld
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Lisa Flake
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, USA
- Center On Human Development and Disability, University of Washington, Seattle, USA
| | - Annette M Estes
- Center On Human Development and Disability, University of Washington, Seattle, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, USA
| | - Juhi Pandey
- The Children's Hospital of Philadelphia and University of Pennsylvania, Center for Autism Research, Philadelphia, USA
| | - Robert T Schultz
- The Children's Hospital of Philadelphia and University of Pennsylvania, Center for Autism Research, Philadelphia, USA
| | - Tanya St John
- Center On Human Development and Disability, University of Washington, Seattle, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
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2
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Burrows CA, Lasch C, Gross J, Girault JB, Rutsohn J, Wolff JJ, Swanson MR, Lee CM, Dager SR, Cornea E, Stephens R, Styner M, John TS, Pandey J, Deva M, Botteron KN, Estes AM, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Gilmore JH, Shen MD, Piven J, Elison JT. Associations between early trajectories of amygdala development and later school-age anxiety in two longitudinal samples. Dev Cogn Neurosci 2024; 65:101333. [PMID: 38154378 PMCID: PMC10792190 DOI: 10.1016/j.dcn.2023.101333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
Amygdala function is implicated in the pathogenesis of autism spectrum disorder (ASD) and anxiety. We investigated associations between early trajectories of amygdala growth and anxiety and ASD outcomes at school age in two longitudinal studies: high- and low-familial likelihood for ASD, Infant Brain Imaging Study (IBIS, n = 257) and typically developing (TD) community sample, Early Brain Development Study (EBDS, n = 158). Infants underwent MRI scanning at up to 3 timepoints from neonate to 24 months. Anxiety was assessed at 6-12 years. Linear multilevel modeling tested whether amygdala volume growth was associated with anxiety symptoms at school age. In the IBIS sample, children with higher anxiety showed accelerated amygdala growth from 6 to 24 months. ASD diagnosis and ASD familial likelihood were not significant predictors. In the EBDS sample, amygdala growth from birth to 24 months was associated with anxiety. More anxious children had smaller amygdala volume and slower rates of amygdala growth. We explore reasons for the contrasting results between high-familial likelihood for ASD and TD samples, grounding results in the broader literature of variable associations between early amygdala volume and later anxiety. Results have the potential to identify mechanisms linking early amygdala growth to later anxiety in certain groups.
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Affiliation(s)
| | - Carolyn Lasch
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Julia Gross
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Joshua Rutsohn
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Meghan R Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Chimei M Lee
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Stephen R Dager
- Deptartment of Radiology, University of Washington Medical Center, Seattle, WA, USA
| | - Emil Cornea
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca Stephens
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Tanya St John
- University of Washington Autism Center, University of Washington, Seattle, WA, USA
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Meera Deva
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Annette M Estes
- University of Washington Autism Center, University of Washington, Seattle, WA, USA; Deptartment of Speech and Hearing Science, University of Washington, Seattle, WA, USA
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - John H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jed T Elison
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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3
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Garic D, McKinstry RC, Rutsohn J, Slomowitz R, Wolff J, MacIntyre LC, Weisenfeld LAH, Kim SH, Pandey J, St. John T, Estes AM, Schultz RT, Hazlett HC, Dager SR, Botteron KN, Styner M, Piven J, Shen MD. Enlarged Perivascular Spaces in Infancy and Autism Diagnosis, Cerebrospinal Fluid Volume, and Later Sleep Problems. JAMA Netw Open 2023; 6:e2348341. [PMID: 38113043 PMCID: PMC10731509 DOI: 10.1001/jamanetworkopen.2023.48341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/03/2023] [Indexed: 12/21/2023] Open
Abstract
Importance Perivascular spaces (PVS) and cerebrospinal fluid (CSF) are essential components of the glymphatic system, regulating brain homeostasis and clearing neural waste throughout the lifespan. Enlarged PVS have been implicated in neurological disorders and sleep problems in adults, and excessive CSF volume has been reported in infants who develop autism. Enlarged PVS have not been sufficiently studied longitudinally in infancy or in relation to autism outcomes or CSF volume. Objective To examine whether enlarged PVS are more prevalent in infants who develop autism compared with controls and whether they are associated with trajectories of extra-axial CSF volume (EA-CSF) and sleep problems in later childhood. Design, Setting, and Participants This prospective, longitudinal cohort study used data from the Infant Brain Imaging Study. Magnetic resonance images were acquired at ages 6, 12, and 24 months (2007-2017), with sleep questionnaires performed between ages 7 and 12 years (starting in 2018). Data were collected at 4 sites in North Carolina, Missouri, Pennsylvania, and Washington. Data were analyzed from March 2021 through August 2022. Exposure PVS (ie, fluid-filled channels that surround blood vessels in the brain) that are enlarged (ie, visible on magnetic resonance imaging). Main Outcomes and Measures Outcomes of interest were enlarged PVS and EA-CSF volume from 6 to 24 months, autism diagnosis at 24 months, sleep problems between ages 7 and 12 years. Results A total of 311 infants (197 [63.3%] male) were included: 47 infants at high familial likelihood for autism (ie, having an older sibling with autism) who were diagnosed with autism at age 24 months, 180 high likelihood infants not diagnosed with autism, and 84 low likelihood control infants not diagnosed with autism. Sleep measures at school-age were available for 109 participants. Of infants who developed autism, 21 (44.7%) had enlarged PVS at 24 months compared with 48 infants (26.7%) in the high likelihood but no autism diagnosis group (P = .02) and 22 infants in the control group (26.2%) (P = .03). Across all groups, enlarged PVS at 24 months was associated with greater EA-CSF volume from ages 6 to 24 months (β = 4.64; 95% CI, 0.58-8.72; P = .002) and more frequent night wakings at school-age (F = 7.76; η2 = 0.08; P = .006). Conclusions and Relevance These findings suggest that enlarged PVS emerged between ages 12 and 24 months in infants who developed autism. These results add to a growing body of evidence that, along with excessive CSF volume and sleep dysfunction, the glymphatic system could be dysregulated in infants who develop autism.
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Affiliation(s)
- Dea Garic
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Joshua Rutsohn
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Jason Wolff
- Department of Educational Psychology, University of Minnesota Twin Cities College of Education and Human Development, Minneapolis
| | - Leigh C. MacIntyre
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
| | - Leigh Anne H. Weisenfeld
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Sun Hyung Kim
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Tanya St. John
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Annette M. Estes
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Robert T. Schultz
- University of Washington Autism Center, University of Washington, Seattle
| | - Heather C. Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Stephen R. Dager
- Department of Radiology, University of Washington Medical Center, Seattle
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Mark D. Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
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4
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Rodriguez U, Deddah T, Kim SH, Shen M, Botteron KN, Louis Collins D, Dager SR, Estes AM, Evans AC, Hazlett HC, McKinstry R, Shultz RT, Piven J, Dang Q, Styner M, Prieto JC. IcoConv : Explainable brain cortical surface analysis for ASD classification. Shape Med Imaging (2023) 2023; 14350:248-258. [PMID: 38425723 PMCID: PMC10902712 DOI: 10.1007/978-3-031-46914-5_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
In this study, we introduce a novel approach for the analysis and interpretation of 3D shapes, particularly applied in the context of neuroscientific research. Our method captures 2D perspectives from various vantage points of a 3D object. These perspectives are subsequently analyzed using 2D Convolutional Neural Networks (CNNs), uniquely modified with custom pooling mechanisms. We sought to assess the efficacy of our approach through a binary classification task involving subjects at high risk for Autism Spectrum Disorder (ASD). The task entailed differentiating between high-risk positive and high-risk negative ASD cases. To do this, we employed brain attributes like cortical thickness, surface area, and extra-axial cerebral spinal measurements. We then mapped these measurements onto the surface of a sphere and subsequently analyzed them via our bespoke method. One distinguishing feature of our method is the pooling of data from diverse views using our icosahedron convolution operator. This operator facilitates the efficient sharing of information between neighboring views. A significant contribution of our method is the generation of gradient-based explainability maps, which can be visualized on the brain surface. The insights derived from these explainability images align with prior research findings, particularly those detailing the brain regions typically impacted by ASD. Our innovative approach thereby substantiates the known understanding of this disorder while potentially unveiling novel areas of study.
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Affiliation(s)
| | | | | | - Mark Shen
- University of North Carolina, Chapel Hill, NC
| | | | | | | | | | | | | | | | | | | | - Quyen Dang
- University of North Carolina, Chapel Hill, NC
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5
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Dimian AF, Estes AM, Dager S, Piven J, Wolff JJ. Predicting self-injurious behavior at age three among infant siblings of children with autism. Autism Res 2023; 16:1670-1680. [PMID: 37439184 DOI: 10.1002/aur.2981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/16/2023] [Indexed: 07/14/2023]
Abstract
Existing research suggests that self-injurious behavior (SIB) is a relatively common interfering behavior that can occur across the lifespan of individuals with autism spectrum disorder (ASD). We previously reported that SIB or proto-injurious SIB at 12 months was related to increased risk of SIB at 24 months among a preschool sample of children with a high familial likelihood for ASD (Dimian et al., 2017). In the present study, we extend these findings, examine SIB occurrence, and associated potential risk factors at 36 months. The present sample included 149 infants with an older sibling with ASD (65.8% male) who completed assessments at ages 12, 24, and 36 months. Descriptive analyses and binary logistic regression models were utilized. SIB was more prevalent among those children who received a diagnosis of ASD. Logistic regression indicated that presence of SIB, stereotypy, hyper- and hypo- sensory responsivity, and lower intellectual functioning at age 12 months significantly predicted the occurrence of SIB at 36 months. These findings have implications for understanding developmental processes culminating in persistent SIB and may inform prevention programming.
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Affiliation(s)
- Adele F Dimian
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
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6
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MacDuffie KE, Stein JL, Doherty D, Jayadev S, Girault JB, Emmons KA, Glass MR, Dempsey JC, Marrus N, Botteron KN, Dager SR, Estes AM, Piven J, Wilfond BS. Donor perspectives on informed consent and use of biospecimens for brain organoid research. Stem Cell Reports 2023; 18:1389-1393. [PMID: 37352851 PMCID: PMC10362497 DOI: 10.1016/j.stemcr.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/25/2023] Open
Abstract
Debates about the ethics of human brain organoids have proceeded without the input of individuals whose brains are being modeled. Interviews with donors of biospecimens for brain organoid research revealed overall enthusiasm for brain organoids as a tool for biomedical discovery, alongside a desire for ongoing engagement with research teams to learn the results of the research, to allow transfer of decision-making authority over time, and to ensure ethical boundaries are not crossed. Future work is needed to determine the most feasible and resource-efficient way to longitudinally engage donors participating in brain organoid research.
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Affiliation(s)
- Katherine E MacDuffie
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA.
| | - Jason L Stein
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Dan Doherty
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Suman Jayadev
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Jessica B Girault
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Katherine A Emmons
- Department of Speech & Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Madison Rose Glass
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jennifer C Dempsey
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Annette M Estes
- Department of Speech & Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Benjamin S Wilfond
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA
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7
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Lau BK, Emmons KA, Lee AKC, Munson J, Dager SR, Estes AM. The prevalence and developmental course of auditory processing differences in autistic children. Autism Res 2023. [PMID: 37376987 DOI: 10.1002/aur.2961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/19/2023] [Indexed: 06/29/2023]
Abstract
Auditory processing differences, including hyper- or hyposensitivity to sound, aversions to sound, and difficulty listening under noisy, real-world conditions, are commonly reported in autistic individuals. However, the developmental course and functional impact of these auditory processing differences are unclear. In this study, we investigate the prevalence, developmental trajectory, and functional impact of auditory processing differences in autistic children throughout childhood using a longitudinal study design. Auditory processing differences were measured using the Short Sensory Profile, a caregiver questionnaire, in addition to adaptive behaviors and disruptive/concerning behaviors at 3, 6, and 9 years of age. Our results showed that auditory processing differences were reported in greater than 70% of the autistic children in our sample at all three timepoints, maintained a high prevalence through 9 years of age, and were associated with increased disruptive/concerning behaviors and difficulty with adaptive behaviors. Furthermore, in our sample of children, auditory processing differences at age 3 years predicted disruptive/concerning behaviors and difficulty with adaptive behaviors at age 9 years. These findings warrant further investigations of the potential benefit of incorporating measures of auditory processing during routine clinical evaluations as well as interventions targeting auditory processing differences in autistic children.
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Affiliation(s)
- Bonnie K Lau
- Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | | | - Adrian K C Lee
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
- Institute for Learning and Brain Sciences, University of Washington, Seattle, WA, USA
| | - Jeff Munson
- Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Annette M Estes
- UW Autism Center, University of Washington, Seattle, WA, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
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8
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Stallworthy IC, Berry D, Davis S, Wolff JJ, Burrows CA, Swanson MR, Grzadzinski RL, Botteron K, Dager SR, Estes AM, Schultz RT, Piven J, Elison JT, Pruett JR, Marrus N. Quantifying latent social motivation and its associations with joint attention and language in infants at high and low likelihood for autism spectrum disorder. Dev Sci 2023; 26:e13336. [PMID: 36222317 PMCID: PMC10591497 DOI: 10.1111/desc.13336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/11/2022] [Accepted: 09/09/2022] [Indexed: 01/29/2023]
Abstract
Social motivation-the psychobiological predisposition for social orienting, seeking social contact, and maintaining social interaction-manifests in early infancy and is hypothesized to be foundational for social communication development in typical and atypical populations. However, the lack of infant social-motivation measures has hindered delineation of associations between infant social motivation, other early-arising social abilities such as joint attention, and language outcomes. To investigate how infant social motivation contributes to joint attention and language, this study utilizes a mixed longitudinal sample of 741 infants at high (HL = 515) and low (LL = 226) likelihood for ASD. Using moderated nonlinear factor analysis (MNLFA), we incorporated items from parent-report measures to establish a novel latent factor model of infant social motivation that exhibits measurement invariance by age, sex, and familial ASD likelihood. We then examined developmental associations between 6- and 12-month social motivation, joint attention at 12-15 months, and language at 24 months of age. On average, greater social-motivation growth from 6-12 months was associated with greater initiating joint attention (IJA) and trend-level increases in sophistication of responding to joint attention (RJA). IJA and RJA were both positively associated with 24-month language abilities. There were no additional associations between social motivation and future language in our path model. These findings substantiate a novel, theoretically driven approach to modeling social motivation and suggest a developmental cascade through which social motivation impacts other foundational skills. These findings have implications for the timing and nature of intervention targets to support social communication development in infancy. HIGHLIGHTS: We describe a novel, theoretically based model of infant social motivation wherein multiple parent-reported indicators contribute to a unitary latent social-motivation factor. Analyses revealed social-motivation factor scores exhibited measurement invariance for a longitudinal sample of infants at high and low familial ASD likelihood. Social-motivation growth from ages 6-12 months is associated with better 12-15-month joint attention abilities, which in turn are associated with greater 24-month language skills. Findings inform timing and targets of potential interventions to support healthy social communication in the first year of life.
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Affiliation(s)
| | - Daniel Berry
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Savannah Davis
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Meghan R. Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Rebecca L. Grzadzinski
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelly Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Stephen R. Dager
- Departments of Radiology and Bioengineering, University of Washington, Seattle, Washington, USA
| | - Annette M. Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Robert T. Schultz
- Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
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St. John T, Estes AM, Hazlett HC, Marrus N, Burrows CA, Donovan K, Torres Gomez S, Grzadzinski RL, Parish-Morris J, Smith R, Styner M, Garic D, Pandey J, Lee CM, Schultz RT, Botteron KN, Zwaigenbaum L, Piven J, Dager SR. Association of Sex With Neurobehavioral Markers of Executive Function in 2-Year-Olds at High and Low Likelihood of Autism. JAMA Netw Open 2023; 6:e2311543. [PMID: 37140923 PMCID: PMC10160873 DOI: 10.1001/jamanetworkopen.2023.11543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/19/2023] [Indexed: 05/05/2023] Open
Abstract
Importance Children with autism and their siblings exhibit executive function (EF) deficits early in development, but associations between EF and biological sex or early brain alterations in this population are largely unexplored. Objective To investigate the interaction of sex, autism likelihood group, and structural magnetic resonance imaging alterations on EF in 2-year-old children at high familial likelihood (HL) and low familial likelihood (LL) of autism, based on having an older sibling with autism or no family history of autism in first-degree relatives. Design, Setting, and Participants This prospective cohort study assessed 165 toddlers at HL (n = 110) and LL (n = 55) of autism at 4 university-based research centers. Data were collected from January 1, 2007, to December 31, 2013, and analyzed between August 2021 and June 2022 as part of the Infant Brain Imaging Study. Main Outcomes and Measures Direct assessments of EF and acquired structural magnetic resonance imaging were performed to determine frontal lobe, parietal lobe, and total cerebral brain volume. Results A total of 165 toddlers (mean [SD] age, 24.61 [0.95] months; 90 [54%] male, 137 [83%] White) at HL for autism (n = 110; 17 diagnosed with ASD) and LL for autism (n = 55) were studied. The toddlers at HL for autism scored lower than the toddlers at LL for autism on EF tests regardless of sex (mean [SE] B = -8.77 [4.21]; 95% CI, -17.09 to -0.45; η2p = 0.03). With the exclusion of toddlers with autism, no group (HL vs LL) difference in EF was found in boys (mean [SE] difference, -7.18 [4.26]; 95% CI, 1.24-15.59), but EF was lower in HL girls than LL girls (mean [SE] difference, -9.75 [4.34]; 95% CI, -18.32 to -1.18). Brain-behavior associations were examined, controlling for overall cerebral volume and developmental level. Sex differences in EF-frontal (B [SE] = 16.51 [7.43]; 95% CI, 1.36-31.67; η2p = 0.14) and EF-parietal (B [SE] = 17.68 [6.99]; 95% CI, 3.43-31.94; η2p = 0.17) associations were found in the LL group but not the HL group (EF-frontal: B [SE] = -1.36 [3.87]; 95% CI, -9.07 to 6.35; η2p = 0.00; EF-parietal: B [SE] = -2.81 [4.09]; 95% CI, -10.96 to 5.34; η2p = 0.01). Autism likelihood group differences in EF-frontal (B [SE] = -9.93 [4.88]; 95% CI, -19.73 to -0.12; η2p = 0.08) and EF-parietal (B [SE] = -15.44 [5.18]; 95% CI, -25.86 to -5.02; η2p = 0.16) associations were found in girls not boys (EF-frontal: B [SE] = 6.51 [5.88]; 95% CI, -5.26 to 18.27; η2p = 0.02; EF-parietal: B [SE] = 4.18 [5.48]; 95% CI, -6.78 to 15.15; η2p = 0.01). Conclusions and Relevance This cohort study of toddlers at HL and LL of autism suggests that there is an association between sex and EF and that brain-behavior associations in EF may be altered in children at HL of autism. Furthermore, EF deficits may aggregate in families, particularly in girls.
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Affiliation(s)
- Tanya St. John
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Annette M. Estes
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Heather C. Hazlett
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St Louis, Missouri
| | | | - Kevin Donovan
- Department of Biostatistics, University of Pennsylvania, Philadelphia
| | - Santiago Torres Gomez
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Rebecca L. Grzadzinski
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Julia Parish-Morris
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Rachel Smith
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
| | - Martin Styner
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Dea Garic
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Chimei M. Lee
- Department of Pediatrics, University of Minnesota, Minneapolis
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine in St Louis, Missouri
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Stephen R. Dager
- Department of Radiology, University of Washington Medical Center, Seattle
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10
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Worthley E, Grzadzinski R, Zwaigenbaum L, Dager SR, Estes AM, Hazlett HC, Schultz RT, Piven J, Wolff JJ. Sensory Profiles in Relation to Later Adaptive Functioning Among Toddlers at High-Familial Likelihood for Autism. J Autism Dev Disord 2023:10.1007/s10803-022-05869-5. [PMID: 37017863 DOI: 10.1007/s10803-022-05869-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2022] [Indexed: 04/06/2023]
Abstract
This study investigated the extent to which sensory responsivity in infancy contributes to adaptive behavior development among toddlers at high-familial likelihood for autism. Prospective, longitudinal data were analyzed for 218 children, 58 of whom received an autism diagnosis. Results indicated that sensory profiles at age one year (hyperresponsivity, sensory seeking) were negatively associated with later adaptive behavior, particularly for socialization, at age 3 years regardless of diagnostic status. These results suggest that early differences in sensory responsivity may have downstream developmental consequences related to social development among young children with high-familial likelihood for autism.
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Affiliation(s)
- Emma Worthley
- University of Minnesota, 56 East River Road, 55455, Minneapolis, MN, USA
| | - Rebecca Grzadzinski
- University of North Carolina at Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
| | | | - Stephen R Dager
- University of Washington, 1701 NE Columbia Rd, 98195, Seattle, WA, USA
| | - Annette M Estes
- University of Washington, 1701 NE Columbia Rd, 98195, Seattle, WA, USA
| | - Heather C Hazlett
- University of North Carolina at Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
| | - Robert T Schultz
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, 19104, Philadelphia, PA, USA
| | - Joseph Piven
- University of North Carolina at Chapel Hill, 321 S Columbia St, 27516, Chapel Hill, NC, USA
| | - Jason J Wolff
- University of Minnesota, 56 East River Road, 55455, Minneapolis, MN, USA.
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11
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Welsh JP, Munson J, St John T, Meehan CN, Tran Abraham E, Reitz FB, Begay KK, Dager SR, Estes AM. Relationship of Impairments in Associative Learning With Intellectual Disability and Cerebellar Hypoplasia in Autistic Children. Neurology 2023; 100:e639-e650. [PMID: 36443015 PMCID: PMC9946191 DOI: 10.1212/wnl.0000000000201496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/15/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The severity of autism spectrum disorder (ASD) varies widely and is associated with intellectual disability (ID) and brain dysmorphology. We tested the hypothesis that the heterogeneity of ASD can be accounted for, in part, by altered associative learning measured by eye-blink conditioning (EBC) paradigms, used to test for forebrain and cerebellar dysfunction across the full range of ASD severity and intellectual ability. METHODS Children in this cohort study were diagnosed with ASD or typical development (TD); most children were recruited from a 10-year longitudinal study. Outcome measures were the percentage and timing of conditioned eye-blink responses (CRs) acquired to a tone, recorded photometrically and related to measures of ASD severity, IQ, and age 2 brain morphometry by MRI. A sequence of trace and delay EBC was used. Analysis of variance, t test, and logistic regression (LR) were used. RESULTS Sixty-two children were studied at school age. Nine children with ASD with ID since age 2 (ASD + ID; IQ = 49 ± 6; 11.9 ± 0.2 years old [±SD]) learned more slowly than 30 children with TD (IQ = 120 ± 16; 10.5 ± 1.5 years old [±SD]) during trace EBC and showed atypically early-onset CRs (1.4 SD pre-TD) related to hypoplasia of the cerebellum at age 2 but not of the amygdala, hippocampus, or cerebral cortex. Conversely, 16 children with ASD with robust intellectual development since age 2 (IQ = 100 ± 3; 12.0 ± 0.4 years old [±SD]) learned typically but showed early-onset CRs only during long-delay EBC (0.8 SD pre-TD) unrelated to hypoplasia of any measured brain area. Using 16 EBC measures, binary LR classified ASD and TD with 80% accuracy (95% CI = 72-88%), 81% sensitivity (95% CI = 69-92%), and 79% specificity (95% CI = 68-91%); multinomial LR more accurately classified children based on ID (94% accuracy, 95% CI = 89-100%) than ASD severity (85% accuracy, 95% CI = 77-93%). Separate analyses of 39 children with MRI (2.1 ± 0.3 years old [±SD]) indicated that cerebellar hypoplasia did not predict ASD + ID over ages 2-4 (Cohen d = 0.3) compared with early-onset CRs during age 11 trace EBC (Cohen d = -1.3). DISCUSSION Trace EBC reveals the relationship between cerebellar hypoplasia and ASD + ID likely by engaging cerebrocerebellar circuits involved in intellectual ability and implicit timing. Follow-up prospective studies using associative learning can determine whether ID can be predicted in children with early ASD diagnoses.
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Affiliation(s)
- John P Welsh
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma.
| | - Jeffrey Munson
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
| | - Tanya St John
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
| | - Christina N Meehan
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
| | - Elise Tran Abraham
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
| | - Frederick B Reitz
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
| | - K Kawena Begay
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
| | - Stephen R Dager
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
| | - Annette M Estes
- From the Departments of Pediatrics (J.P.W.), Psychiatry and Behavioral Sciences (J.M.), Speech and Hearing Sciences (T.S.J., A.M.E.), Radiology (S.R.D.), and Bioengineering (S.R.D.), University of Washington; Center for Integrative Brain Research (J.P.W.), Seattle Children's Research Institute; University of Washington Center on Human Development and Disability (J.P.W., J.M., T.S.J., K.K.B., S.R.D., A.M.E.); University of Washington Autism Center (J.P.W., J.M., T.S.J., C.N.M., E.T.A., F.B.R., K.K.B., S.R.D., A.M.E.); and School of Education (K.K.B.), University of Washington Tacoma
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12
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Ravi S, Bradshaw A, Abdi H, Meera SS, Parish-Morris J, Yankowitz L, Paterson S, Dager SR, Burrows CA, Chappell C, St.John T, Estes AM, Piven J, Swanson MR. Are early social communication skills a harbinger for language development in infants later diagnosed autistic?-A longitudinal study using a standardized social communication assessment. Front Commun (Lausanne) 2022; 7:977724. [PMID: 37168581 PMCID: PMC10167971 DOI: 10.3389/fcomm.2022.977724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The early emergence of social communication challenges and their impact on language in infants later diagnosed with autism has sparked many early intervention programs that target social communication skills. While research has consistently shown lower scores on social communication assessments in the first year of life, there is limited research at 12-months exploring associations between different dimensions of social communication and later language. Understanding associations between early social communication skills and language would enhance our ability to choose high priority intervention goals that will impact downstream language skills. The current study used a standardized assessment to profile social communication skills across 516 infants with a high (HL) or low likelihood (LL-Neg) for autism (84% White, 60% Male), based on the presence of a sibling with autism in the family. The primary aim of the study was to profile social communication skill development in the second year of life and to evaluate associations between social communication skills and later language. HL infants who met criteria for autism (HL-ASD, N = 81) demonstrated widespread reductions in social communication skills at 12-months compared to HL infants who did not meet criteria for autism (HL-Neg, N = 277) and LL-Neg (N = 158) infants. Across all infants in the study, those with better social communication skills at 12-months had better language at 24-months. However, within group analyses indicated that infants who met criteria for autism did not show this developmental coupling until 24-months-of-age at which point social communication was positively associated with downstream language skills. The cascading pattern of reduced social communication skills as well as overall significant positive associations with later language provide further evidence for the need to support developing social communication skills prior to formal autism diagnosis, a goal that could possibly be reached through pre-emptive interventions.
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Affiliation(s)
- Shruthi Ravi
- Department of Psychology, The University of Texas at Dallas, Richardson, TX, United States
| | - Allison Bradshaw
- Department of Psychology, The University of Texas at Dallas, Richardson, TX, United States
| | - Hervé Abdi
- Department of Psychology, The University of Texas at Dallas, Richardson, TX, United States
| | - Shoba Sreenath Meera
- Department of Speech Pathology & Audiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Julia Parish-Morris
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Lisa Yankowitz
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah Paterson
- The James S. McDonnell Foundation, St. Louis, MO, United States
| | - Stephen R. Dager
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Catherine A. Burrows
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Chad Chappell
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Tanya St.John
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Annette M. Estes
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Meghan R. Swanson
- Department of Psychology, The University of Texas at Dallas, Richardson, TX, United States
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13
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Burrows CA, Grzadzinski RL, Donovan K, Stallworthy IC, Rutsohn J, St John T, Marrus N, Parish-Morris J, MacIntyre L, Hampton J, Pandey J, Shen MD, Botteron KN, Estes AM, Dager SR, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Truong KN, Piven J, Elison JT. A Data-Driven Approach in an Unbiased Sample Reveals Equivalent Sex Ratio of Autism Spectrum Disorder-Associated Impairment in Early Childhood. Biol Psychiatry 2022; 92:654-662. [PMID: 35965107 PMCID: PMC10062179 DOI: 10.1016/j.biopsych.2022.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/12/2022] [Accepted: 05/30/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Sex differences in the prevalence of neurodevelopmental disorders are particularly evident in autism spectrum disorder (ASD). Heterogeneous symptom presentation and the potential of measurement bias hinder early ASD detection in females and may contribute to discrepant prevalence estimates. We examined trajectories of social communication (SC) and restricted and repetitive behaviors (RRBs) in a sample of infant siblings of children with ASD, adjusting for age- and sex-based measurement bias. We hypothesized that leveraging a prospective elevated familial likelihood sample, deriving data-driven behavioral constructs, and accounting for measurement bias would reveal less discrepant sex ratios than are typically seen in ASD. METHODS We conducted direct assessments of ASD symptoms at 6 to 9, 12 to 15, 24, and 36 to 60 months of age (total nobservations = 1254) with infant siblings of children with ASD (n = 377) and a lower ASD-familial-likelihood comparison group (n = 168; nobservations = 527). We established measurement invariance across age and sex for separate models of SC and RRB. We then conducted latent class growth mixture modeling with the longitudinal data and evaluated for sex differences in trajectory membership. RESULTS We identified 2 latent classes in the SC and RRB models with equal sex ratios in the high-concern cluster for both SC and RRB. Sex differences were also observed in the SC high-concern cluster, indicating that girls classified as having elevated social concerns demonstrated milder symptoms than boys in this group. CONCLUSIONS This novel approach for characterizing ASD symptom progression highlights the utility of assessing and adjusting for sex-related measurement bias and identifying sex-specific patterns of symptom emergence.
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Affiliation(s)
- Catherine A Burrows
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota.
| | - Rebecca L Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kevin Donovan
- Department of Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Isabella C Stallworthy
- Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota
| | - Joshua Rutsohn
- Department of Biostatistics, Gillings School of Global PubLic Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tanya St John
- UW Autism Center, Center on Human Development & Disability, University of Washington, Seattle, Washington
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Julia Parish-Morris
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Leigh MacIntyre
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
| | - Jacqueline Hampton
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Neuroscience Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelly N Botteron
- Department of Radiology, University of Washington Medical Center, Seattle, Washington; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Annette M Estes
- UW Autism Center, Center on Human Development & Disability, University of Washington, Seattle, Washington; Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington
| | - Stephen R Dager
- Department of Radiology, University of Washington Medical Center, Seattle, Washington
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Alberta, Canada
| | - Kinh N Truong
- Department of Biostatistics, Gillings School of Global PubLic Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jed T Elison
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota; Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota
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14
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Sung S, Fenoglio A, Wolff JJ, Schultz RT, Botteron KN, Dager SR, Estes AM, Hazlett HC, Zwaigenbaum L, Piven J, Elison JT. Examining the factor structure and discriminative utility of the Infant Behavior Questionnaire-Revised in infant siblings of autistic children. Child Dev 2022; 93:1398-1413. [PMID: 35485579 PMCID: PMC9544485 DOI: 10.1111/cdev.13781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Using the Infant Behavior Questionnaire-Revised in a longitudinal sample of infant siblings of autistic children (HR; n = 427, 171 female, 83.4% White) and a comparison group of low-risk controls (LR, n = 200, 86 female, 81.5% White), collected between 2007 and 2017, this study identified an invariant factor structure of temperament traits across groups at 6 and 12 months. Second, after partitioning the groups by familial risk and diagnostic outcome at 24 months, results reveal an endophenotypic pattern of Positive Emotionality at both 6 and 12 months, (HR-autism spectrum disorder [ASD] < HR-no-ASD < LR). Third, increased 'Duration of Orienting' at 12 months was associated with lower scores on the 24-month developmental outcomes in HR infants. These findings may augment efforts for early identification of ASD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Joseph Piven
- University of North Carolina—Chapel HillChapel HillNorth CarolinaUSA
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Girault JB, Donovan K, Hawks Z, Talovic M, Forsen E, Elison JT, Shen MD, Swanson MR, Wolff JJ, Kim SH, Nishino T, Davis S, Snyder AZ, Botteron KN, Estes AM, Dager SR, Hazlett HC, Gerig G, McKinstry R, Pandey J, Schultz RT, St John T, Zwaigenbaum L, Todorov A, Truong Y, Styner M, Pruett JR, Constantino JN, Piven J. Infant Visual Brain Development and Inherited Genetic Liability in Autism. Am J Psychiatry 2022; 179:573-585. [PMID: 35615814 PMCID: PMC9356977 DOI: 10.1176/appi.ajp.21101002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Autism spectrum disorder (ASD) is heritable, and younger siblings of ASD probands are at higher likelihood of developing ASD themselves. Prospective MRI studies of siblings report that atypical brain development precedes ASD diagnosis, although the link between brain maturation and genetic factors is unclear. Given that familial recurrence of ASD is predicted by higher levels of ASD traits in the proband, the authors investigated associations between proband ASD traits and brain development among younger siblings. METHODS In a sample of 384 proband-sibling pairs (89 pairs concordant for ASD), the authors examined associations between proband ASD traits and sibling brain development at 6, 12, and 24 months in key MRI phenotypes: total cerebral volume, cortical surface area, extra-axial cerebrospinal fluid, occipital cortical surface area, and splenium white matter microstructure. Results from primary analyses led the authors to implement a data-driven approach using functional connectivity MRI at 6 months. RESULTS Greater levels of proband ASD traits were associated with larger total cerebral volume and surface area and larger surface area and reduced white matter integrity in components of the visual system in siblings who developed ASD. This aligned with weaker functional connectivity between several networks and the visual system among all siblings during infancy. CONCLUSIONS The findings provide evidence that specific early brain MRI phenotypes of ASD reflect quantitative variation in familial ASD traits. Multimodal anatomical and functional convergence on cortical regions, fiber pathways, and functional networks involved in visual processing suggest that inherited liability has a role in shaping the prodromal development of visual circuitry in ASD.
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Affiliation(s)
- Jessica B Girault
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Educational Psychology (Wolff), University of Minnesota, Minneapolis;Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Kevin Donovan
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Zoë Hawks
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Muhamed Talovic
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Elizabeth Forsen
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Jed T Elison
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Meghan R Swanson
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Jason J Wolff
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Sun Hyung Kim
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Tomoyuki Nishino
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Savannah Davis
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Abraham Z Snyder
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Kelly N Botteron
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Annette M Estes
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Stephen R Dager
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Guido Gerig
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Robert McKinstry
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Juhi Pandey
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Robert T Schultz
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Tanya St John
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Lonnie Zwaigenbaum
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Alexandre Todorov
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Young Truong
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Martin Styner
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - John R Pruett
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - John N Constantino
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
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- Carolina Institute for Developmental Disabilities (Girault, Forsen, Shen, Hazlett, Piven), Department of Psychiatry (Girault, Shen, Kim, Hazlett, Styner, Piven), Department of Biostatistics (Donovan, Truong), and ; Department of Psychological and Brain Sciences (Hawks) and Department of Psychiatry (Talovic, Nishino, Davis, Botteron, Todorov, Pruett, Constantino), Washington University School of Medicine in St. Louis; Institute of Child Development (Elison) and Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Tex. (Swanson); Department of Radiology, Washington University in St. Louis (Snyder, McKinstry); Department of Speech and Hearing Science, University of Washington, Seattle (Estes, St. John); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Tandon School of Engineering, New York University, New York (Gerig); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum)
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Shen MD, Swanson MR, Wolff JJ, Elison JT, Girault JB, Kim SH, Smith RG, Graves MM, Weisenfeld LAH, Flake L, MacIntyre L, Gross JL, Burrows CA, Fonov VS, Collins DL, Evans AC, Gerig G, McKinstry RC, Pandey J, St John T, Zwaigenbaum L, Estes AM, Dager SR, Schultz RT, Styner MA, Botteron KN, Hazlett HC, Piven J. Subcortical Brain Development in Autism and Fragile X Syndrome: Evidence for Dynamic, Age- and Disorder-Specific Trajectories in Infancy. Am J Psychiatry 2022; 179:562-572. [PMID: 35331012 PMCID: PMC9762548 DOI: 10.1176/appi.ajp.21090896] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Previous research has demonstrated that the amygdala is enlarged in children with autism spectrum disorder (ASD). However, the precise onset of this enlargement during infancy, how it relates to later diagnostic behaviors, whether the timing of enlargement in infancy is specific to the amygdala, and whether it is specific to ASD (or present in other neurodevelopmental disorders, such as fragile X syndrome) are all unknown. METHODS Longitudinal MRIs were acquired at 6-24 months of age in 29 infants with fragile X syndrome, 58 infants at high likelihood for ASD who were later diagnosed with ASD, 212 high-likelihood infants not diagnosed with ASD, and 109 control infants (1,099 total scans). RESULTS Infants who developed ASD had typically sized amygdala volumes at 6 months, but exhibited significantly faster amygdala growth between 6 and 24 months, such that by 12 months the ASD group had significantly larger amygdala volume (Cohen's d=0.56) compared with all other groups. Amygdala growth rate between 6 and 12 months was significantly associated with greater social deficits at 24 months when the infants were diagnosed with ASD. Infants with fragile X syndrome had a persistent and significantly enlarged caudate volume at all ages between 6 and 24 months (d=2.12), compared with all other groups, which was significantly associated with greater repetitive behaviors. CONCLUSIONS This is the first MRI study comparing fragile X syndrome and ASD in infancy, demonstrating strikingly different patterns of brain and behavior development. Fragile X syndrome-related changes were present from 6 months of age, whereas ASD-related changes unfolded over the first 2 years of life, starting with no detectable group differences at 6 months. Increased amygdala growth rate between 6 and 12 months occurs prior to social deficits and well before diagnosis. This gradual onset of brain and behavior changes in ASD, but not fragile X syndrome, suggests an age- and disorder-specific pattern of cascading brain changes preceding autism diagnosis.
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Affiliation(s)
- Mark D Shen
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Meghan R Swanson
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Jason J Wolff
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Jed T Elison
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Sun Hyung Kim
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Rachel G Smith
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Michael M Graves
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Leigh Anne H Weisenfeld
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Lisa Flake
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Leigh MacIntyre
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Julia L Gross
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Catherine A Burrows
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Vladimir S Fonov
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - D Louis Collins
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Alan C Evans
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Guido Gerig
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Robert C McKinstry
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Juhi Pandey
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Tanya St John
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Lonnie Zwaigenbaum
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Annette M Estes
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Stephen R Dager
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Robert T Schultz
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Martin A Styner
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Kelly N Botteron
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities and Department of Psychiatry (Shen, Girault, Kim, Smith, Graves, Weisenfeld, Gross, Styner, Hazlett, Piven) and UNC Neuroscience Center (Shen), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill; Department of Educational Psychology (Wolff), Institute of Child Development (Elison), and Department of Pediatrics (Elison, Burrows), University of Minnesota, Minneapolis; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (Flake, McKinstry, Botteron); Department of Radiology, University of Washington Medical Center, Seattle (Dager); Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia (Pandey, Schultz); Computer Science and Engineering, NYU Tandon School of Engineering, New York (Gerig); Montreal Neurological Institute, McGill University, Montreal (MacIntyre, Fonov, Collins, Evans); Department of Pediatrics, University of Alberta, Edmonton, Canada (Zwaigenbaum); Department of Speech and Hearing Science, University of Washington, Seattle (St. John, Estes); School of Behavioral and Brain Sciences, University of Texas at Dallas (Swanson)
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17
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Chaxiong P, Burrows C, Botteron KN, Dager SR, Estes AM, Hazlett HC, Schultz RT, Zwaigenbaum L, Piven J, Wolff J. Relations of Restricted and Repetitive Behaviors to Social Skills in Toddlers with Autism. J Autism Dev Disord 2022; 52:1423-1434. [PMID: 33956255 PMCID: PMC8571122 DOI: 10.1007/s10803-021-05014-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 12/21/2022]
Abstract
We examined the relations of restricted and repetitive behaviors (RRB; insistence on sameness, repetitive sensory-motor, self-injurious behavior) to social skills overall and aspects that comprise social skills as measured by the VABS-II (coping skills, play/leisure time, interpersonal relationships) in 24- (n = 63) and 36-month old (n = 35), high-familial-risk toddlers with ASD. Hierarchical linear regression results indicated that repetitive sensory-motor was the best predictor of social skills overall. Secondary results indicated that all three RRB subtypes were associated with each subdomain of social skills; however, repetitive sensory-motor was the strongest and most consistent among these effects. While our results suggests a general negative relation of subtypes of RRB to aspects of adaptive social function, repetitive sensory-motor behaviors may be of particular relevance to the development of social skills during toddlerhood.
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Affiliation(s)
- Pang Chaxiong
- University of Minnesota, 56 East River Road, Minneapolis, MN, 55455, USA
| | - Catherine Burrows
- University of Minnesota, 56 East River Road, Minneapolis, MN, 55455, USA
| | - Kelly N Botteron
- Washington University in St. Louis, 660 S Euclid Ave, St. Louis, MO, 63110, USA
| | - Stephen R Dager
- University of Washington, 1701 NE Columbia Rd, Seattle, WA, 98195, USA
| | - Annette M Estes
- University of Washington, 1701 NE Columbia Rd, Seattle, WA, 98195, USA
| | - Heather C Hazlett
- University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27516, USA
| | - Robert T Schultz
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | | | - Joseph Piven
- University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27516, USA
| | - Jason Wolff
- University of Minnesota, 56 East River Road, Minneapolis, MN, 55455, USA.
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18
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Stallworthy I, Lasch C, Berry D, Wolff JJ, Pruett JR, Marrus N, Swanson MR, Botteron KN, Dager SR, Estes AM, Hazlett HC, Schultz RT, Zwaigenbaum L, Piven J, Elison JT. Variability in Responding to Joint Attention Cues in the First Year is Associated With Autism Outcome. J Am Acad Child Adolesc Psychiatry 2022; 61:413-422. [PMID: 33965519 PMCID: PMC8636536 DOI: 10.1016/j.jaac.2021.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 02/10/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE With development, infants become increasingly responsive to the many attention-sharing cues of adults; however, little work has examined how this ability emerges in typical development or in the context of early autism spectrum disorder (ASD). This study characterized variation in the type of cue needed to elicit a response to joint attention (RJA) using the Dimensional Joint Attention Assessment (DJAA) during naturalistic play. METHOD We measured the average redundancy of cue type required for infants to follow RJA bids from an experimenter, as well as their response consistency, in 268 infants at high (HR, n = 68) and low (LR, N = 200) familial risk for ASD. Infants were assessed between 8 and 18 months of age and followed up with developmental and clinical assessments at 24 or 36 months. Our sample consisted of LR infants, as well as HR infants who did (HR-ASD) and did not (HR-neg) develop ASD at 24 months. RESULTS We found that HR and LR infants developed abilities to respond to less redundant (more sophisticated) RJA cues at different rates, and that HR-ASD infants displayed delayed abilities, identifiable as early as 9 months, compared to both HR-neg and LR infants. Interestingly, results suggest that HR-neg infants may exhibit a propensity to respond to less redundant (more sophisticated) RJA cues relative to both HR-ASD and LR infants. CONCLUSION Using an approach to characterize variable performance of RJA cue-reading abilities, findings from this study enhance our understanding of both typical and ASD-related proficiencies and deficits in RJA development.
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Affiliation(s)
| | | | | | | | - John R. Pruett
- Washington University School of Medicine, St. Louis, Missouri
| | - Natasha Marrus
- Washington University School of Medicine, St. Louis, Missouri
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19
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Tunç B, Pandey J, John TS, Meera SS, Maldarelli JE, Zwaigenbaum L, Hazlett HC, Dager SR, Botteron KN, Girault JB, McKinstry RC, Verma R, Elison JT, Pruett JR, Piven J, Estes AM, Schultz RT. Diagnostic shifts in autism spectrum disorder can be linked to the fuzzy nature of the diagnostic boundary: a data-driven approach. J Child Psychol Psychiatry 2021; 62:1236-1245. [PMID: 33826159 PMCID: PMC8601115 DOI: 10.1111/jcpp.13406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Diagnostic shifts at early ages may provide invaluable insights into the nature of separation between autism spectrum disorder (ASD) and typical development. Recent conceptualizations of ASD suggest the condition is only fuzzily separated from non-ASD, with intermediate cases between the two. These intermediate cases may shift along a transition region over time, leading to apparent instability of diagnosis. METHODS We used a cohort of children with high ASD risk, by virtue of having an older sibling with ASD, assessed at 24 months (N = 212) and 36 months (N = 191). We applied machine learning to empirically characterize the classification boundary between ASD and non-ASD, using variables quantifying developmental and adaptive skills. We computed the distance of children to the classification boundary. RESULTS Children who switched diagnostic labels from 24 to 36 months, in both directions, (dynamic group) had intermediate phenotypic profiles. They were closer to the classification boundary compared to children who had stable diagnoses, both at 24 months (Cohen's d = .52) and at 36 months (d = .75). The magnitude of change in distance between the two time points was similar for the dynamic and stable groups (Cohen's d = .06), and diagnostic shifts were not associated with a large change. At the individual level, a few children in the dynamic group showed substantial change. CONCLUSIONS Our results suggested that a diagnostic shift was largely due to a slight movement within a transition region between ASD and non-ASD. This fact highlights the need for more vigilant surveillance and intervention strategies. Young children with intermediate phenotypes may have an increased susceptibility to gain or lose their diagnosis at later ages, calling attention to the inherently dynamic nature of early ASD diagnoses.
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Affiliation(s)
- Birkan Tunç
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.,Correspondence to: Birkan Tunç, PhD,
| | - Juhi Pandey
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tanya St. John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195, USA
| | - Shoba S. Meera
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Jennifer E. Maldarelli
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Heather C. Hazlett
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, , NC 27599, USA
| | - Stephen R. Dager
- Department of Radiology and Bioengineering, University of Washington, Seattle, WA 98195, USA
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jessica B. Girault
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, , NC 27599, USA
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Ragini Verma
- DiCIPHR (Diffusion and Connectomics in Precision Healthcare Research) Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Joseph Piven
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, , NC 27599, USA
| | - Annette M. Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195, USA.,Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Robert T. Schultz
- Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Biomedical and Health Informatics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Pediatrics, University of Pennsylvania, Philadelphia, PA 19104, USA
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20
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Burrows CA, Bodfish JW, Wolff JJ, Vollman EP, Altschuler MR, Botteron KN, Dager SR, Estes AM, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Piven J, Elison JT. Cataloguing and characterizing interests in typically developing toddlers and toddlers who develop ASD. Autism Res 2021; 14:1710-1723. [PMID: 34021722 PMCID: PMC8714188 DOI: 10.1002/aur.2543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/16/2021] [Accepted: 05/03/2021] [Indexed: 11/06/2022]
Abstract
Intense interests are common in children with and without autism spectrum disorder (ASD), and little research has characterized aspects of interests that are unique to or shared among children with and without ASD. We aimed to characterize interests in a sample of infants at high-familial-risk (HR) and low-familial-risk (LR) for ASD using a novel interview. Participants included HR siblings who were diagnosed with ASD at 24 months (HR-ASD, n = 56), HR siblings who did not receive an ASD diagnosis at 24 months (HR-Neg, n = 187), and a LR comparison group (n = 109). We developed and collected data with the Intense Interests Inventory at 18- and 24-months of age, a semi-structured interview that measures intensity and peculiarity of interests in toddlers and preschool-aged children. Intensity of interests differed by familial risk at 24 months, with HR-ASD and HR-Neg groups demonstrating equivalent intensity of interests that were higher than the LR group. By contrast, peculiarity of interest differed by ASD diagnosis, with the HR-ASD group showing more peculiar interests than the HR-Neg and LR groups at 24 months. At 18 months the HR-ASD group had more peculiar interests than the LR group, though no differences emerged in intensity of interests. This measure may be useful in identifying clinically-relevant features of interests in young children with ASD. We also replicated previous findings of males showing more intense interests at 18 months in our non-ASD sample. These results reveal new information about the nature of interests and preoccupations in the early autism phenotype. LAY SUMMARY: Intense interests are common in young children with autism and their family members. Intense interests are also prevalent among typically-developing children, and especially boys. Here we catalog interests and features of these interests in a large sample of toddlers enriched for autism risk. Children who had family members with autism had more intense interests, and those who developed autism themselves had more unusual interests at 24 months. These results highlight the importance of different aspects of interest in autism.
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Affiliation(s)
- Catherine A Burrows
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - James W Bodfish
- Department of Hearing & Speech Sciences, Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elayne P Vollman
- Department of Psychology and Comparative Human Development, University of Chicago, Chicago, Illinois, USA
| | - Melody R Altschuler
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Annette M Estes
- Center on Human Development and Disability, University of Washington, Seattle, Washington, USA
| | - Heather C Hazlett
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - John R Pruett
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Robert T Schultz
- Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
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21
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MacDuffie KE, Estes AM, Peay HL, Pruett JR, Wilfond BS. The Ethics of Predicting Autism Spectrum Disorder in Infancy. J Am Acad Child Adolesc Psychiatry 2021; 60:942-945. [PMID: 33482291 PMCID: PMC8629367 DOI: 10.1016/j.jaac.2021.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 12/27/2022]
Abstract
Toward the end of a routine check-in appointment with your young patient-a 3-year-old boy recently diagnosed with autism spectrum disorder (ASD)-his mother shares concerns about his infant sister, currently 6 months old. The mother is aware that her daughter is at increased risk for ASD. She requests a magnetic resonance imaging (MRI) scan of her infant's brain, based on research she has read showing that MRI can be used to predict which infants will go on to develop ASD. The mother communicates that she is eager to know whether her daughter is going to develop autism so that she and her husband can prepare financially, and so she can place her daughter on the long waitlist for autism-specific services in her local community. As this family's psychiatrist, how should you respond to her request?
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Affiliation(s)
- Katherine E MacDuffie
- University of Washington, Seattle; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Washington.
| | | | - Holly L Peay
- Research Triangle Institute International, Research Triangle Park, North Carolina
| | - John R Pruett
- Washington University School of Medicine, St. Louis, Missouri
| | - Benjamin S Wilfond
- University of Washington, Seattle; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Washington
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22
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Meera SS, Donovan K, Wolff JJ, Zwaigenbaum L, Elison JT, Kinh T, Shen MD, Estes AM, Hazlett HC, Watson LR, Baranek GT, Swanson MR, St John T, Burrows CA, Schultz RT, Dager SR, Botteron KN, Pandey J, Piven J. Towards a Data-Driven Approach to Screen for Autism Risk at 12 Months of Age. J Am Acad Child Adolesc Psychiatry 2021; 60:968-977. [PMID: 33161063 PMCID: PMC8127075 DOI: 10.1016/j.jaac.2020.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 07/19/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to develop a classifier for infants at 12 months of age based on a parent-report measure (the First Year Inventory 2.0 [FYI]), for the following reasons: (1) to classify infants at elevated risk, above and beyond that attributable to familial risk status for ASD; and (2) to serve as a starting point to refine an approach for risk estimation in population samples. METHOD A total of 54 high-familial risk (HR) infants later diagnosed with ASD (HR-ASD), 183 HR infants not diagnosed with ASD at 24 months of age (HR-Neg), and 72 low-risk controls participated in the study. All infants contributed FYI data at 12 months of age and had a diagnostic assessment for ASD at age 24 months. A data-driven, cross-validated analytic approach was used to develop a classifier to determine screening accuracy (eg, sensitivity) of the FYI to classify HR-ASD and HR-Neg. RESULTS The newly developed FYI classifier had an estimated sensitivity of 0.71 (95% CI: 0.50, 0.91) and specificity of 0.72 (95% CI: 0.49, 0.91). CONCLUSION This classifier demonstrates the potential to improve current screening for ASD risk at 12 months of age in infants already at elevated familial risk for ASD, increasing opportunities for detection of autism risk in infancy. Findings from this study highlight the utility of combining parent-report measures with machine learning approaches.
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Affiliation(s)
- Shoba S Meera
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill; The National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Kevin Donovan
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | | | - Lonnie Zwaigenbaum
- University of Alberta, Edmonton, Canada; and the Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Canada
| | | | - Truong Kinh
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | | | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | - Linda R Watson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | | | | | | | | | | | | | | | - Juhi Pandey
- Children's Hospital of Philadelphia, University of Pennsylvania
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
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MacDuffie KE, Estes AM, Harrington LT, Peay HL, Piven J, Pruett JR, Wolff JJ, Wilfond BS. Presymptomatic Detection and Intervention for Autism Spectrum Disorder. Pediatrics 2021; 147:e2020032250. [PMID: 33853890 PMCID: PMC8085996 DOI: 10.1542/peds.2020-032250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 11/24/2022] Open
Abstract
Universal screening for autism spectrum disorder (ASD) is recommended during pediatric primary care visits in the first 2 years of life. However, many children are missed by initial screening and not diagnosed with ASD until years later. Research efforts are underway to develop and evaluate new objective measures of risk for ASD that can be used in infancy, before symptoms emerge. Initial studies with these tests, particularly MRI-based screening for infants at high familial risk, have shown promise but have not yet been evaluated in clinical trials. We present the study design for a hypothetical clinical trial that would combine presymptomatic detection and intervention for ASD and consider, through commentaries from diverse perspectives, the ethical issues that should be anticipated in advance of beginning such trials. Commentators Drs Pruett and Piven address the social value of the proposed research and importance of researcher-bioethicist collaborations. Drs Estes and Wolff discuss the clinical potential and challenges of developing presymptomatic interventions for infants at risk for ASD. Dr Harrington takes a neurodiversity view of presymptomatic prediction and intervention and their implications for autistic identity and quality of life. Finally, Drs MacDuffie, Peay and Wilfond consider the potential risks and benefits that must be evaluated and weighed in the next phases of research on presymptomatic detection and intervention for ASD.
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Affiliation(s)
- Katherine E MacDuffie
- Departments of Speech and Hearing Sciences and
- Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington
| | | | | | - Holly L Peay
- Research Triangle Institute International, Research Triangle Park, North Carolina
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - John R Pruett
- School of Medicine, Washington University, St Louis, Missouri; and
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Benjamin S Wilfond
- Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington
- Pediatrics, University of Washington, Seattle, Washington
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24
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Peng L, Lin L, Lin Y, Chen YW, Mo Z, Vlasova RM, Kim SH, Evans AC, Dager SR, Estes AM, McKinstry RC, Botteron KN, Gerig G, Schultz RT, Hazlett HC, Piven J, Burrows CA, Grzadzinski RL, Girault JB, Shen MD, Styner MA. Longitudinal Prediction of Infant MR Images With Multi-Contrast Perceptual Adversarial Learning. Front Neurosci 2021; 15:653213. [PMID: 34566556 PMCID: PMC8458966 DOI: 10.3389/fnins.2021.653213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/09/2021] [Indexed: 11/28/2022] Open
Abstract
The infant brain undergoes a remarkable period of neural development that is crucial for the development of cognitive and behavioral capacities (Hasegawa et al., 2018). Longitudinal magnetic resonance imaging (MRI) is able to characterize the developmental trajectories and is critical in neuroimaging studies of early brain development. However, missing data at different time points is an unavoidable occurrence in longitudinal studies owing to participant attrition and scan failure. Compared to dropping incomplete data, data imputation is considered a better solution to address such missing data in order to preserve all available samples. In this paper, we adapt generative adversarial networks (GAN) to a new application: longitudinal image prediction of structural MRI in the first year of life. In contrast to existing medical image-to-image translation applications of GANs, where inputs and outputs share a very close anatomical structure, our task is more challenging as brain size, shape and tissue contrast vary significantly between the input data and the predicted data. Several improvements over existing GAN approaches are proposed to address these challenges in our task. To enhance the realism, crispness, and accuracy of the predicted images, we incorporate both a traditional voxel-wise reconstruction loss as well as a perceptual loss term into the adversarial learning scheme. As the differing contrast changes in T1w and T2w MR images in the first year of life, we incorporate multi-contrast images leading to our proposed 3D multi-contrast perceptual adversarial network (MPGAN). Extensive evaluations are performed to assess the qualityand fidelity of the predicted images, including qualitative and quantitative assessments of the image appearance, as well as quantitative assessment on two segmentation tasks. Our experimental results show that our MPGAN is an effective solution for longitudinal MR image data imputation in the infant brain. We further apply our predicted/imputed images to two practical tasks, a regression task and a classification task, in order to highlight the enhanced task-related performance following image imputation. The results show that the model performance in both tasks is improved by including the additional imputed data, demonstrating the usability of the predicted images generated from our approach.
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Affiliation(s)
- Liying Peng
- Department of Computer Science, Zhejiang University, Hangzhou, China
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Lanfen Lin
- Department of Computer Science, Zhejiang University, Hangzhou, China
| | - Yusen Lin
- Department of Electrical and Computer Engineering Department, University of Maryland, College Park, MD, United States
| | - Yen-wei Chen
- Department of Information Science and Engineering, Ritsumeikan University, Shiga, Japan
| | - Zhanhao Mo
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Roza M. Vlasova
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Sun Hyung Kim
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Alan C. Evans
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Stephen R. Dager
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Annette M. Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, United States
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, United States
| | - Kelly N. Botteron
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, United States
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Guido Gerig
- Department of Computer Science and Engineering, New York University, New York, NY, United States
| | - Robert T. Schultz
- Center for Autism Research, Department of Pediatrics, Children's Hospital of Philadelphia, and University of Pennsylvania, Philadelphia, PA, United States
| | - Heather C. Hazlett
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Joseph Piven
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Catherine A. Burrows
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Rebecca L. Grzadzinski
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Jessica B. Girault
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Mark D. Shen
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
- UNC Neuroscience Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Martin A. Styner
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, United States
- *Correspondence: Martin A. Styner
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25
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MacDuffie KE, Turner-Brown L, Estes AM, Wilfond BS, Dager SR, Pandey J, Zwaigenbaum L, Botteron KN, Pruett JR, Piven J, Peay HL. "If He Has it, We Know What to Do": Parent Perspectives on Familial Risk for Autism Spectrum Disorder. J Pediatr Psychol 2020; 45:121-130. [PMID: 31764985 DOI: 10.1093/jpepsy/jsz076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 09/06/2019] [Accepted: 09/16/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Predictive testing for familial disorders can guide healthcare and reproductive decisions. Familial disorders with onset in childhood (e.g., autism spectrum disorder [ASD]) are promising targets for presymptomatic prediction; however, little is known about parent perceptions of risk to their children in the presymptomatic period. The current study examined risk perceptions in parents of infants at high familial risk for ASD enrolled in a longitudinal study of brain and behavior development. METHODS Semistructured interviews were conducted with 37 parents of high-risk infants during the presymptomatic window (3-15 months) that precedes an ASD diagnosis. Infants were identified as high familial risk due to having an older sibling with ASD. Parent interview responses were coded and interpreted to distill emerging themes. RESULTS The majority of parents were aware of the increased risk of ASD for their infants, and risk perceptions were influenced by comparisons to their older child with ASD. Parents reported a variety of negative emotions in response to perceived risk, including worry, fear, and sadness, and described impacts of perceived risk on their behavior: increased vigilance to emerging symptoms, altered reproductive and healthcare decisions, and seeking ongoing assessment through research. CONCLUSIONS Parents of children at high familial risk for childhood-onset disorders like ASD face a period of challenging uncertainty during early development. In anticipation of a future in which presymptomatic testing for ASD is made available, it is important to understand how parents react to and cope with the elevated-but still highly uncertain-risk conveyed by family history.
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Affiliation(s)
- Katherine E MacDuffie
- University of Washington Autism Center, Department of Speech & Hearing Sciences.,Seattle Children's Hospital, Treuman Katz Center for Pediatric Bioethics
| | - Lauren Turner-Brown
- University of North Carolina at Chapel Hill, TEACCH Autism Program, Department of Psychiatry
| | - Annette M Estes
- University of Washington Autism Center, Department of Speech & Hearing Sciences
| | - Benjamin S Wilfond
- Seattle Children's Hospital, Treuman Katz Center for Pediatric Bioethics
| | | | - Juhi Pandey
- Children's Hospital of Philadelphia, Center for Autism Research
| | | | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine in Saint Louis
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine in Saint Louis
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Holly L Peay
- Research Triangle Institute, Center for Newborn Screening, Ethics, and Disability Studies
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26
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Mostapha M, Kim SH, Evans AC, Dager SR, Estes AM, McKinstry RC, Botteron KN, Gerig G, Pizer SM, Schultz RT, Hazlett HC, Piven J, Girault JB, Shen MD, Styner MA. A Novel Method for High-Dimensional Anatomical Mapping of Extra-Axial Cerebrospinal Fluid: Application to the Infant Brain. Front Neurosci 2020; 14:561556. [PMID: 33132824 PMCID: PMC7561674 DOI: 10.3389/fnins.2020.561556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/21/2020] [Indexed: 12/21/2022] Open
Abstract
Cerebrospinal fluid (CSF) plays an essential role in early postnatal brain development. Extra-axial CSF (EA-CSF) volume, which is characterized by CSF in the subarachnoid space surrounding the brain, is a promising marker in the early detection of young children at risk for neurodevelopmental disorders. Previous studies have focused on global EA-CSF volume across the entire dorsal extent of the brain, and not regionally-specific EA-CSF measurements, because no tools were previously available for extracting local EA-CSF measures suitable for localized cortical surface analysis. In this paper, we propose a novel framework for the localized, cortical surface-based analysis of EA-CSF. The proposed processing framework combines probabilistic brain tissue segmentation, cortical surface reconstruction, and streamline-based local EA-CSF quantification. The quantitative analysis of local EA-CSF was applied to a dataset of typically developing infants with longitudinal MRI scans from 6 to 24 months of age. There was a high degree of consistency in the spatial patterns of local EA-CSF across age using the proposed methods. Statistical analysis of local EA-CSF revealed several novel findings: several regions of the cerebral cortex showed reductions in EA-CSF from 6 to 24 months of age, and specific regions showed higher local EA-CSF in males compared to females. These age-, sex-, and anatomically-specific patterns of local EA-CSF would not have been observed if only a global EA-CSF measure were utilized. The proposed methods are integrated into a freely available, open-source, cross-platform, user-friendly software tool, allowing neuroimaging labs to quantify local extra-axial CSF in their neuroimaging studies to investigate its role in typical and atypical brain development.
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Affiliation(s)
- Mahmoud Mostapha
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, United States
| | - Sun Hyung Kim
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Alan C Evans
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, United States
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, United States
| | - Kelly N Botteron
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, United States.,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Guido Gerig
- Department of Computer Science and Engineering, New York University, New York, NY, United States
| | - Stephen M Pizer
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, United States
| | - Robert T Schultz
- Department of Pediatrics, Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Heather C Hazlett
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States.,Carolina Institute for Developmental Disabilities, UNC School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Joseph Piven
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States.,Carolina Institute for Developmental Disabilities, UNC School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Jessica B Girault
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States.,Carolina Institute for Developmental Disabilities, UNC School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Mark D Shen
- Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States.,Carolina Institute for Developmental Disabilities, UNC School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States.,UNC Neuroscience Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Martin A Styner
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, United States.,Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
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27
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MacDuffie KE, Shen MD, Dager SR, Styner MA, Kim SH, Paterson S, Pandey J, John TS, Elison JT, Wolff JJ, Swanson MR, Botteron KN, Zwaigenbaum L, Piven J, Estes AM. Sleep Onset Problems and Subcortical Development in Infants Later Diagnosed With Autism Spectrum Disorder. Am J Psychiatry 2020; 177:518-525. [PMID: 32375538 PMCID: PMC7519575 DOI: 10.1176/appi.ajp.2019.19060666] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Sleep patterns in children with autism spectrum disorder (ASD) appear to diverge from typical development in the second or third year of life. Little is known, however, about the occurrence of sleep problems in infants who later develop ASD and possible effects on early brain development. In a longitudinal neuroimaging study of infants at familial high or low risk for ASD, parent-reported sleep onset problems were examined in relation to subcortical brain volumes in the first 2 years of life. METHODS A total of 432 infants were included across three study groups: infants at high risk who developed ASD (N=71), infants at high risk who did not develop ASD (N=234), and infants at low risk (N=127). Sleep onset problem scores (derived from an infant temperament measure) were evaluated in relation to longitudinal high-resolution T1 and T2 structural imaging data acquired at 6, 12, and 24 months of age. RESULTS Sleep onset problems were more common at 6-12 months among infants who later developed ASD. Infant sleep onset problems were related to hippocampal volume trajectories from 6 to 24 months only for infants at high risk who developed ASD. Brain-sleep relationships were specific to the hippocampus; no significant relationships were found with volume trajectories of other subcortical structures examined (the amygdala, caudate, globus pallidus, putamen, and thalamus). CONCLUSIONS These findings provide initial evidence that sleep onset problems in the first year of life precede ASD diagnosis and are associated with altered neurodevelopmental trajectories in infants at high familial risk who go on to develop ASD. If replicated, these findings could provide new insights into a potential role of sleep difficulties in the development of ASD.
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Affiliation(s)
| | - Mark D. Shen
- Department of Psychiatry, University of North Carolina Chapel Hill
| | | | - Martin A. Styner
- Department of Psychiatry, University of North Carolina Chapel Hill,Biomedical Research Imaging Center, University of North Carolina Chapel Hill
| | - Sun Hyung Kim
- Department of Psychiatry, University of North Carolina Chapel Hill
| | - Sarah Paterson
- Department of Psychology, Temple University, Philadelphia
| | - Juhi Pandey
- Department of Child Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia
| | - Tanya St. John
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, Minneapolis
| | - Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis
| | - Meghan R. Swanson
- Department of Behavioral and Brain Sciences, University of Texas at Dallas
| | - Kelly N. Botteron
- Department of Child Psychiatry, Washington University School of Medicine in St. Louis
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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28
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Eggebrecht AT, Elison JT, Feczko E, Todorov A, Wolff JJ, Kandala S, Adams CM, Snyder AZ, Lewis JD, Estes AM, Zwaigenbaum L, Botteron KN, McKinstry RC, Constantino JN, Evans A, Hazlett HC, Dager S, Paterson SJ, Schultz RT, Styner MA, Gerig G, Das S, Kostopoulos P, Schlaggar BL, Petersen SE, Piven J, Pruett JR. Corrigendum: Joint Attention and Brain Functional Connectivity in Infants and Toddlers. Cereb Cortex 2020; 30:3433-3434. [DOI: 10.1093/cercor/bhaa092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 11/04/2019] [Accepted: 01/07/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA
| | - Eric Feczko
- Department of Behavioral Neuroscience, Oregon Health & Sciences, Portland, OR 97239, USA
| | - Alexandre Todorov
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sridhar Kandala
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Chloe M Adams
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Abraham Z Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - John D Lewis
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195, USA
| | - Lonnie Zwaigenbaum
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), Edmonton, AB T6G 2B7, Canada
| | - Kelly N Botteron
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - John N Constantino
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Alan Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Heather C Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, WA 98195, USA
| | - Sarah J Paterson
- The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Robert T Schultz
- The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Martin A Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Guido Gerig
- Tandon School of Engineering, New York University, Brooklyn, NY 11201, USA
| | - Samir Das
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Penelope Kostopoulos
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Bradley L Schlaggar
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Steven E Petersen
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
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29
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Schmied A, Soda T, Gerig G, Styner M, Swanson MR, Elison JT, Shen MD, McKinstry RC, Pruett JR, Botteron KN, Estes AM, Dager SR, Hazlett HC, Schultz RT, Piven J, Wolff JJ. Sex differences associated with corpus callosum development in human infants: A longitudinal multimodal imaging study. Neuroimage 2020; 215:116821. [PMID: 32276067 DOI: 10.1016/j.neuroimage.2020.116821] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/21/2020] [Accepted: 03/27/2020] [Indexed: 02/02/2023] Open
Abstract
The corpus callosum (CC) is the largest connective pathway in the human brain, linking cerebral hemispheres. There is longstanding debate in the scientific literature whether sex differences are evident in this structure, with many studies indicating the structure is larger in females. However, there are few data pertaining to this issue in infancy, during which time the most rapid developmental changes to the CC occur. In this study, we examined longitudinal brain imaging data collected from 104 infants at ages 6, 12, and 24 months. We identified sex differences in brain-size adjusted CC area and thickness characterized by a steeper rate of growth in males versus females from ages 6-24 months. In contrast to studies of older children and adults, CC size was larger for male compared to female infants. Based on diffusion tensor imaging data, we found that CC thickness is significantly associated with underlying microstructural organization. However, we observed no sex differences in the association between microstructure and thickness, suggesting that the role of factors such as axon density and/or myelination in determining CC size is generally equivalent between sexes. Finally, we found that CC length was negatively associated with nonverbal ability among females.
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Affiliation(s)
- Astrid Schmied
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Takahiro Soda
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Guido Gerig
- Department of Computer Science & Engineering, New York University, New York City, NY, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Meghan R Swanson
- School of Behavioral & Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Mark D Shen
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Heather C Hazlett
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Robert T Schultz
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA.
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30
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Swanson MR, Donovan K, Paterson S, Wolff JJ, Parish-Morris J, Meera SS, Watson LR, Estes AM, Marrus N, Elison JT, Shen MD, McNeilly HB, MacIntyre L, Zwaigenbaum L, St John T, Botteron K, Dager S, Piven J. Early language exposure supports later language skills in infants with and without autism. Autism Res 2019; 12:1784-1795. [PMID: 31254329 DOI: 10.1002/aur.2163] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/10/2019] [Indexed: 11/08/2022]
Abstract
The way that parents communicate with their typically developing infants is associated with later infant language development. Here we aim to show that these associations are observed in infants subsequently diagnosed with autism spectrum disorder (ASD). This study had three groups: high-familial-risk infants who did not have ASD (n = 46); high-familial-risk infants who had ASD (n = 14); and low-familial-risk infants who exhibited typical development (n = 36). All-day home language recordings were collected at 9 and 15 months, and language skills were assessed at 24 months. Across all infants in the study, including those with ASD, a richer home language environment (e.g., hearing more adult words and experiencing more conversational turns) at 9 and 15 months was associated with better language skills. Higher parental educational attainment was associated with a richer home language environment. Mediation analyses showed that the effect of education on child language skills was explained by the richness of the home language environment. Exploratory analyses revealed that typically developing infants experience an increase in caregiver-child conversational turns across 9-15 months, a pattern not seen in children with ASD. The current study shows that parent behavior during the earliest stages of life can have a significant impact on later development, highlighting the home language environment as means to support development in infants with ASD. Autism Res 2019, 12: 1784-1795. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: It has long been understood that caregiver speech supports language skills in typically developing infants. In this study, parents of infants who were later diagnosed with ASD and parents of infants in the control groups completed all-day home language recordings. We found that for all infants in our study, those who heard more caregiver speech had better language skills later in life. Parental education level was also related to how much caregiver speech an infant experienced.
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Affiliation(s)
- Meghan R Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas.,Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kevin Donovan
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sarah Paterson
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Julia Parish-Morris
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shoba S Meera
- Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Linda R Watson
- Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Natasha Marrus
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Mark D Shen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heidi B McNeilly
- Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leigh MacIntyre
- McGill Center for Integrative Neuroscience, McGill University, Montreal, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Canada.,Autism Research Centre (E209), Glenrose Rehabilitation Hospital, Edmonton, Canada
| | - Tanya St John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Kelly Botteron
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri.,Department of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, Washington
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities (CIDD), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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31
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Wolff JJ, Dimian AF, Botteron KN, Dager SR, Elison JT, Estes AM, Hazlett HC, Schultz RT, Zwaigenbaum L, Piven J. A longitudinal study of parent-reported sensory responsiveness in toddlers at-risk for autism. J Child Psychol Psychiatry 2019; 60:314-324. [PMID: 30350375 PMCID: PMC8919956 DOI: 10.1111/jcpp.12978] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Atypical sensory responsivity and sensory interests are now included in the DSM 5 diagnostic criteria for autism spectrum disorder (ASD) under the broad domain of restricted and repetitive behavior (RRB). However, relatively little is known about the emergence of sensory-related features and their relation to conventionally defined RRB in the first years of life. METHODS Prospective, longitudinal parent-report data using the Sensory Experiences Questionnaire (SEQ) were collected for 331 high-risk toddlers (74 of whom met diagnostic criteria for ASD at age 2) and 135 low-risk controls. Longitudinal profiles for SEQ scores were compared between groups across ages 12-24 months. Associations between SEQ measures and measures of RRB subtypes (based on the Repetitive Behavior Scale, Revised) were also examined. RESULTS Longitudinal profiles for all SEQ scores significantly differed between groups. SEQ scores were elevated for the ASD group from age 12 months, with differences becoming more pronounced across the 12-24 month interval. At both 12 and 24 months, most measures derived from the SEQ were significantly associated with all subtypes of RRB. CONCLUSIONS These findings suggest that differences in sensory responsivity may be evident in high-risk infants later diagnosed with ASD in early toddlerhood, and that the magnitude of these differences increases over the second year of life. The high degree of association between SEQ scores and RRB supports the conceptual alignment of these features but also raises questions as to explanatory mechanisms.
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Affiliation(s)
- Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Adele F. Dimian
- Institute on Community Integration, University of Minnesota, Minneapolis, MN, USA
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephen R. Dager
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, MN, USA
| | - Annette M. Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Heather C. Hazlett
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA,Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA,Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA
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32
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McKinnon CJ, Eggebrecht AT, Todorov A, Wolff JJ, Elison JT, Adams CM, Snyder AZ, Estes AM, Zwaigenbaum L, Botteron KN, McKinstry RC, Marrus N, Evans A, Hazlett HC, Dager SR, Paterson SJ, Pandey J, Schultz RT, Styner MA, Gerig G, Schlaggar BL, Petersen SE, Piven J, Pruett JR. Restricted and Repetitive Behavior and Brain Functional Connectivity in Infants at Risk for Developing Autism Spectrum Disorder. Biol Psychiatry Cogn Neurosci Neuroimaging 2019; 4:50-61. [PMID: 30446435 PMCID: PMC6557405 DOI: 10.1016/j.bpsc.2018.09.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/01/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Restricted and repetitive behaviors (RRBs), detectable by 12 months in many infants in whom autism spectrum disorder (ASD) is later diagnosed, may represent some of the earliest behavioral markers of ASD. However, brain function underlying the emergence of these key behaviors remains unknown. METHODS Behavioral and resting-state functional connectivity (fc) magnetic resonance imaging data were collected from 167 children at high and low familial risk for ASD at 12 and 24 months (n = 38 at both time points). Twenty infants met criteria for ASD at 24 months. We divided RRBs into four subcategories (restricted, stereotyped, ritualistic/sameness, self-injurious) and used a data-driven approach to identify functional brain networks associated with the development of each RRB subcategory. RESULTS Higher scores for ritualistic/sameness behavior were associated with less positive fc between visual and control networks at 12 and 24 months. Ritualistic/sameness and stereotyped behaviors were associated with less positive fc between visual and default mode networks at 12 months. At 24 months, stereotyped and restricted behaviors were associated with more positive fc between default mode and control networks. Additionally, at 24 months, stereotyped behavior was associated with more positive fc between dorsal attention and subcortical networks, whereas restricted behavior was associated with more positive fc between default mode and dorsal attention networks. No significant network-level associations were observed for self-injurious behavior. CONCLUSIONS These observations mark the earliest known description of functional brain systems underlying RRBs, reinforce the construct validity of RRB subcategories in infants, and implicate specific neural substrates for future interventions targeting RRBs.
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Affiliation(s)
- Claire J McKinnon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Biological Sciences Division, University of Chicago, Chicago, Illinois.
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Alexandre Todorov
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Chloe M Adams
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Abraham Z Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | | | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Alan Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Heather C Hazlett
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carborro, North Carolina
| | - Stephen R Dager
- Department of Radiology and Bioengineering, University of Washington, Seattle, Washington
| | - Sarah J Paterson
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin A Styner
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carborro, North Carolina
| | - Guido Gerig
- Tandon School of Engineering, New York University, Brooklyn, New York
| | - Bradley L Schlaggar
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Steven E Petersen
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri
| | - Joseph Piven
- The Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carborro, North Carolina
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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33
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Marrus N, Hall LP, Paterson SJ, Elison JT, Wolff JJ, Swanson MR, Parish-Morris J, Eggebrecht AT, Pruett JR, Hazlett HC, Zwaigenbaum L, Dager S, Estes AM, Schultz RT, Botteron KN, Piven J, Constantino JN. Language delay aggregates in toddler siblings of children with autism spectrum disorder. J Neurodev Disord 2018; 10:29. [PMID: 30348077 PMCID: PMC6198516 DOI: 10.1186/s11689-018-9247-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/20/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Language delay is extremely common in children with autism spectrum disorder (ASD), yet it is unclear whether measurable variation in early language is associated with genetic liability for ASD. Assessment of language development in unaffected siblings of children with ASD can inform whether decreased early language ability aggregates with inherited risk for ASD and serves as an ASD endophenotype. METHODS We implemented two approaches: (1) a meta-analysis of studies comparing language delay, a categorical indicator of language function, and language scores, a continuous metric, in unaffected toddlers at high and low familial risk for ASD, and (2) a parallel analysis of 350 unaffected 24-month-olds in the Infant Brain Imaging Study (IBIS), a prospective study of infants at high and low familial risk for ASD. An advantage of the former was its detection of group differences from pooled data across unique samples; an advantage of the latter was its sensitivity in quantifying early manifestations of language delay while accounting for covariates within a single large sample. RESULTS Meta-analysis showed that high-risk siblings without ASD (HR-noASD) were three to four times more likely to exhibit language delay versus low-risk siblings without ASD (LR-noASD) and had lower mean receptive and expressive language scores. Analyses of IBIS data corroborated that language delay, specifically receptive language delay, was more frequent in the HR-noASD (n = 235) versus LR-noASD group (n = 115). IBIS language scores were continuously and unimodally distributed, with a pathological shift towards decreased language function in HR-noASD siblings. The elevated inherited risk for ASD was associated with lower receptive and expressive language scores when controlling for sociodemographic factors. For receptive but not expressive language, the effect of risk group remained significant even when controlling for nonverbal cognition. CONCLUSIONS Greater frequency of language delay and a lower distribution of language scores in high-risk, unaffected toddler-aged siblings support decreased early language ability as an endophenotype for ASD, with a more pronounced effect for receptive versus expressive language. Further characterization of language development is warranted to refine genetic investigations of ASD and to elucidate factors influencing the progression of core autistic traits and related symptoms.
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Affiliation(s)
- N Marrus
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO 63110 USA
| | - L P Hall
- Department of Psychology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Mail Stop 740, Memphis, TN 38105 USA
| | - S J Paterson
- Department of Psychology, Temple University, 1801 N. Broad St, Philadelphia, PA 19122 USA
| | - J T Elison
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455 USA
| | - J J Wolff
- Department of Educational Psychology, University of Minnesota, 56 East River Road, Minneapolis, MN 55455 USA
| | - M R Swanson
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514 USA
| | - J Parish-Morris
- Children’s Hospital of Philadelphia, University of Pennsylvania, Civic Center Blvd, Philadelphia, PA 19104 USA
| | - A T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 S. Euclid Ave, St Louis, MO 63110 USA
| | - J R Pruett
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO 63110 USA
| | - H C Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514 USA
| | - L Zwaigenbaum
- Department of Pediatrics, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), 8440 112 St NW, Edmonton, AB T6G 2B7 Canada
| | - S Dager
- Department of Radiology, University of Washington, Seattle, 1410 NE Campus Parkway, Seattle, WA 98195 USA
| | - A M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, 1701 NE Columbia Rd, Seattle, WA 98195-7920 USA
| | - R T Schultz
- Children’s Hospital of Philadelphia, University of Pennsylvania, Civic Center Blvd, Philadelphia, PA 19104 USA
| | - K N Botteron
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO 63110 USA
| | - J Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514 USA
| | - J N Constantino
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO 63110 USA
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34
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Emerson RW, Adams C, Nishino T, Hazlett HC, Wolff JJ, Zwaigenbaum L, Constantino JN, Shen MD, Swanson MR, Elison JT, Kandala S, Estes AM, Botteron KN, Collins L, Dager SR, Evans AC, Gerig G, Gu H, McKinstry RC, Paterson S, Schultz RT, Styner M, Schlaggar BL, Pruett JR, Piven J. Functional neuroimaging of high-risk 6-month-old infants predicts a diagnosis of autism at 24 months of age. Sci Transl Med 2018; 9:9/393/eaag2882. [PMID: 28592562 DOI: 10.1126/scitranslmed.aag2882] [Citation(s) in RCA: 196] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 11/15/2016] [Accepted: 02/24/2017] [Indexed: 12/30/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social deficits and repetitive behaviors that typically emerge by 24 months of age. To develop effective early interventions that can potentially ameliorate the defining deficits of ASD and improve long-term outcomes, early detection is essential. Using prospective neuroimaging of 59 6-month-old infants with a high familial risk for ASD, we show that functional connectivity magnetic resonance imaging correctly identified which individual children would receive a research clinical best-estimate diagnosis of ASD at 24 months of age. Functional brain connections were defined in 6-month-old infants that correlated with 24-month scores on measures of social behavior, language, motor development, and repetitive behavior, which are all features common to the diagnosis of ASD. A fully cross-validated machine learning algorithm applied at age 6 months had a positive predictive value of 100% [95% confidence interval (CI), 62.9 to 100], correctly predicting 9 of 11 infants who received a diagnosis of ASD at 24 months (sensitivity, 81.8%; 95% CI, 47.8 to 96.8). All 48 6-month-old infants who were not diagnosed with ASD were correctly classified [specificity, 100% (95% CI, 90.8 to 100); negative predictive value, 96.0% (95% CI, 85.1 to 99.3)]. These findings have clinical implications for early risk assessment and the feasibility of developing early preventative interventions for ASD.
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Affiliation(s)
- Robert W Emerson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA.
| | - Chloe Adams
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Heather Cody Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - John N Constantino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Meghan R Swanson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sridhar Kandala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98105, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.,Mallinckrodt Institute of Radiology, Washington University, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Louis Collins
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Stephen R Dager
- Center on Human Development and Disability, University of Washington, Seattle, WA 98105, USA.,Department of Radiology, University of Washington, Seattle, WA 98105, USA
| | - Alan C Evans
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Guido Gerig
- Tandon School of Engineering, New York University, Brooklyn, NY 11201, USA
| | - Hongbin Gu
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Sarah Paterson
- Center for Autism Research, Department of Pediatrics, Children's Hospital of Philadelphia, and University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Robert T Schultz
- Center for Autism Research, Department of Pediatrics, Children's Hospital of Philadelphia, and University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Martin Styner
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
| | | | - Bradley L Schlaggar
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.,Mallinckrodt Institute of Radiology, Washington University, Washington University School of Medicine, St. Louis, MO 63110, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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35
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Abstract
How does the brain physiology of young children with autism differ from that of typically-developing children?
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Affiliation(s)
- John P Welsh
- Autism Center, University of Washington, Seattle, United States.,Department of Pediatrics, University of Washington, Seattle, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, United States
| | - Annette M Estes
- Autism Center, University of Washington, Seattle, United States.,Department of Pediatrics, University of Washington, Seattle, United States.,Department of Speech and Hearing Sciences, University of Washington, Seattle, United States
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36
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Marrus N, Eggebrecht AT, Todorov A, Elison JT, Wolff JJ, Cole L, Gao W, Pandey J, Shen MD, Swanson MR, Emerson RW, Klohr CL, Adams CM, Estes AM, Zwaigenbaum L, Botteron KN, McKinstry RC, Constantino JN, Evans AC, Hazlett HC, Dager SR, Paterson SJ, Schultz RT, Styner MA, Gerig G, Schlaggar BL, Piven J, Pruett JR. Walking, Gross Motor Development, and Brain Functional Connectivity in Infants and Toddlers. Cereb Cortex 2018; 28:750-763. [PMID: 29186388 PMCID: PMC6057546 DOI: 10.1093/cercor/bhx313] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 10/29/2017] [Accepted: 11/01/2017] [Indexed: 11/14/2022] Open
Abstract
Infant gross motor development is vital to adaptive function and predictive of both cognitive outcomes and neurodevelopmental disorders. However, little is known about neural systems underlying the emergence of walking and general gross motor abilities. Using resting state fcMRI, we identified functional brain networks associated with walking and gross motor scores in a mixed cross-sectional and longitudinal cohort of infants at high and low risk for autism spectrum disorder, who represent a dimensionally distributed range of motor function. At age 12 months, functional connectivity of motor and default mode networks was correlated with walking, whereas dorsal attention and posterior cingulo-opercular networks were implicated at age 24 months. Analyses of general gross motor function also revealed involvement of motor and default mode networks at 12 and 24 months, with dorsal attention, cingulo-opercular, frontoparietal, and subcortical networks additionally implicated at 24 months. These findings suggest that changes in network-level brain-behavior relationships underlie the emergence and consolidation of walking and gross motor abilities in the toddler period. This initial description of network substrates of early gross motor development may inform hypotheses regarding neural systems contributing to typical and atypical motor outcomes, as well as neurodevelopmental disorders associated with motor dysfunction.
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Affiliation(s)
- Natasha Marrus
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Alexandre Todorov
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455,USA
| | - Jason J Wolff
- Department of Educational Psychology,University of Minnesota, 56 East River Road, Minneapolis, MN 55455, USA
| | - Lyndsey Cole
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Wei Gao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, USA
| | - Juhi Pandey
- Children’s Hospital of Philadelphia,University of Pennsylvania, Civic Center Blvd, Philadelphia, PA 19104,USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Meghan R Swanson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Robert W Emerson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Cheryl L Klohr
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Chloe M Adams
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, 1701 NE Columbia Rd., Seattle, WA 98195-7920, USA
| | - Lonnie Zwaigenbaum
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), 8440 112 St NW, Edmonton, Alberta, Canada T6G 2B7
| | - Kelly N Botteron
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - John N Constantino
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Alan C Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, 3801 University St, Montreal, Quebec, Canada H3A 2B4
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, 1410 NE Campus Parkway, Seattle, WA 98195,USA
| | - Sarah J Paterson
- Department of Psychology, Temple University, 1801 N. Broad St., Philadelphia, PA 19122,USA
| | - Robert T Schultz
- Children’s Hospital of Philadelphia,University of Pennsylvania, Civic Center Blvd, Philadelphia, PA 19104,USA
| | - Martin A Styner
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Guido Gerig
- Tandon School of Engineering, New York University, 6 Metro Tech Center, Brooklyn, NY 11201, USA
| | | | - Bradley L Schlaggar
- Department of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St Louis, MO 63110,USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - John R Pruett
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
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Zhou V, Munson JA, Greenson J, Hou Y, Rogers S, Estes AM. An exploratory longitudinal study of social and language outcomes in children with autism in bilingual home environments. Autism 2017; 23:394-404. [PMID: 29237275 DOI: 10.1177/1362361317743251] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Little is known about outcomes of early intervention for children with autism spectrum disorder reared in bilingual homes. There are concerns that social communication deficits among children with autism spectrum disorder may reduce the developmental benefits of early intervention for children with autism spectrum disorder raised in bilingual environments. We conducted an exploratory analysis of cross-sectional and longitudinal data from a larger study to explore associations between home language environment and language ability and social skills in response to early autism spectrum disorder intervention. Participants, aged 12-26 months when recruited, were a subset of a larger 2-year, randomized intervention trial (ClinicalTrials.gov identifier: NCT00698997). Children from bilingual homes ( n = 13) began intervention with lower gesture use but otherwise demonstrated equal baseline language and social abilities as compared with age and nonverbal IQ-matched children from monolingual homes ( n = 24). Significant language growth was exhibited by children from both language groups and there was no moderating effect of home language environment. The bilingual home group demonstrated increased gesture use over the course of intervention as compared with the monolingual home group. Preliminary data revealed no basis for concerns regarding negative impact of a bilingual home environment on language or social development in young children with autism spectrum disorder.
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Affiliation(s)
| | | | | | - Yan Hou
- 2 Harbin Medical University School of Public Health, China
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38
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Mitra A, Snyder AZ, Tagliazucchi E, Laufs H, Elison J, Emerson RW, Shen MD, Wolff JJ, Botteron KN, Dager S, Estes AM, Evans A, Gerig G, Hazlett HC, Paterson SJ, Schultz RT, Styner MA, Zwaigenbaum L, Schlaggar BL, Piven J, Pruett JR, Raichle M. Resting-state fMRI in sleeping infants more closely resembles adult sleep than adult wakefulness. PLoS One 2017; 12:e0188122. [PMID: 29149191 PMCID: PMC5693436 DOI: 10.1371/journal.pone.0188122] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 11/01/2017] [Indexed: 11/19/2022] Open
Abstract
Resting state functional magnetic resonance imaging (rs-fMRI) in infants enables important studies of functional brain organization early in human development. However, rs-fMRI in infants has universally been obtained during sleep to reduce participant motion artifact, raising the question of whether differences in functional organization between awake adults and sleeping infants that are commonly attributed to development may instead derive, at least in part, from sleep. This question is especially important as rs-fMRI differences in adult wake vs. sleep are well documented. To investigate this question, we compared functional connectivity and BOLD signal propagation patterns in 6, 12, and 24 month old sleeping infants with patterns in adult wakefulness and non-REM sleep. We find that important functional connectivity features seen during infant sleep closely resemble those seen during adult sleep, including reduced default mode network functional connectivity. However, we also find differences between infant and adult sleep, especially in thalamic BOLD signal propagation patterns. These findings highlight the importance of considering sleep state when drawing developmental inferences in infant rs-fMRI.
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Affiliation(s)
- Anish Mitra
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
- * E-mail:
| | - Abraham Z. Snyder
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
- Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Enzo Tagliazucchi
- Departamento de Fisica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Helmut Laufs
- Department of Neurology, Christian-Albrechts-University Kiel, Germany
| | - Jed Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Robert W. Emerson
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Mark D. Shen
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jason J. Wolff
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Kelly N. Botteron
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, Washington, United States of America
| | - Annette M. Estes
- Department of Psychology, University of Washington, Seattle, Washington, United States of America
| | - Alan Evans
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Guido Gerig
- Department of Psychiatry, New York University, New York, New York, United States of America
| | - Heather C. Hazlett
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Sarah J. Paterson
- Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Robert T. Schultz
- Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Martin A. Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | | | - Bradley L. Schlaggar
- Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Marcus Raichle
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
- Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
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39
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Lewis JD, Evans AC, Pruett JR, Botteron KN, McKinstry RC, Zwaigenbaum L, Estes AM, Collins DL, Kostopoulos P, Gerig G, Dager SR, Paterson S, Schultz RT, Styner MA, Hazlett HC, Piven J. The Emergence of Network Inefficiencies in Infants With Autism Spectrum Disorder. Biol Psychiatry 2017; 82:176-185. [PMID: 28460842 PMCID: PMC5524449 DOI: 10.1016/j.biopsych.2017.03.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 02/27/2017] [Accepted: 03/09/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a developmental disorder defined by behavioral features that emerge during the first years of life. Research indicates that abnormalities in brain connectivity are associated with these behavioral features. However, the inclusion of individuals past the age of onset of the defining behaviors complicates interpretation of the observed abnormalities: they may be cascade effects of earlier neuropathology and behavioral abnormalities. Our recent study of network efficiency in a cohort of 24-month-olds at high and low familial risk for ASD reduced this confound; we reported reduced network efficiencies in toddlers classified with ASD. The current study maps the emergence of these inefficiencies in the first year of life. METHODS This study uses data from 260 infants at 6 and 12 months of age, including 116 infants with longitudinal data. As in our earlier study, we use diffusion data to obtain measures of the length and strength of connections between brain regions to compute network efficiency. We assess group differences in efficiency within linear mixed-effects models determined by the Akaike information criterion. RESULTS Inefficiencies in high-risk infants later classified with ASD were detected from 6 months onward in regions involved in low-level sensory processing. In addition, within the high-risk infants, these inefficiencies predicted 24-month symptom severity. CONCLUSIONS These results suggest that infants with ASD, even before 6 months of age, have deficits in connectivity related to low-level processing, which contribute to a developmental cascade affecting brain organization and eventually higher-level cognitive processes and social behavior.
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Affiliation(s)
- John D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
| | - Alan C Evans
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri; Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri; Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri
| | - Robert C McKinstry
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - D Louis Collins
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | | | - Guido Gerig
- Tandon School of Engineering, New York University, Brooklyn, New York
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, Washington
| | - Sarah Paterson
- Center for Autism Research, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert T Schultz
- Center for Autism Research, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin A Styner
- Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina; Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, North Carolina
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, North Carolina
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, North Carolina
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40
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Eggebrecht AT, Elison JT, Feczko E, Todorov A, Wolff JJ, Kandala S, Adams CM, Snyder AZ, Lewis JD, Estes AM, Zwaigenbaum L, Botteron KN, McKinstry RC, Constantino JN, Evans A, Hazlett HC, Dager S, Paterson SJ, Schultz RT, Styner MA, Gerig G, Das S, Kostopoulos P, Schlaggar BL, Petersen SE, Piven J, Pruett JR. Joint Attention and Brain Functional Connectivity in Infants and Toddlers. Cereb Cortex 2017; 27:1709-1720. [PMID: 28062515 PMCID: PMC5452276 DOI: 10.1093/cercor/bhw403] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/20/2016] [Indexed: 01/16/2023] Open
Abstract
Initiating joint attention (IJA), the behavioral instigation of coordinated focus of 2 people on an object, emerges over the first 2 years of life and supports social-communicative functioning related to the healthy development of aspects of language, empathy, and theory of mind. Deficits in IJA provide strong early indicators for autism spectrum disorder, and therapies targeting joint attention have shown tremendous promise. However, the brain systems underlying IJA in early childhood are poorly understood, due in part to significant methodological challenges in imaging localized brain function that supports social behaviors during the first 2 years of life. Herein, we show that the functional organization of the brain is intimately related to the emergence of IJA using functional connectivity magnetic resonance imaging and dimensional behavioral assessments in a large semilongitudinal cohort of infants and toddlers. In particular, though functional connections spanning the brain are involved in IJA, the strongest brain-behavior associations cluster within connections between a small subset of functional brain networks; namely between the visual network and dorsal attention network and between the visual network and posterior cingulate aspects of the default mode network. These observations mark the earliest known description of how functional brain systems underlie a burgeoning fundamental social behavior, may help improve the design of targeted therapies for neurodevelopmental disorders, and, more generally, elucidate physiological mechanisms essential to healthy social behavior development.
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Affiliation(s)
- Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA
| | - Eric Feczko
- Department of Behavioral Neuroscience, Oregon Health & Sciences, Portland, OR 97239, USA
| | - Alexandre Todorov
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sridhar Kandala
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Chloe M Adams
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Abraham Z Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - John D Lewis
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195, USA
| | - Lonnie Zwaigenbaum
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), Edmonton, AB T6G 2B7, Canada
| | - Kelly N Botteron
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.,Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - John N Constantino
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Alan Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Heather C Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, WA 98195, USA
| | - Sarah J Paterson
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Robert T Schultz
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Martin A Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Guido Gerig
- Tandon School of Engineering, New York University, Brooklyn, NY 11201, USA
| | - Samir Das
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Penelope Kostopoulos
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | | | - Bradley L Schlaggar
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110,USA
| | - Steven E Petersen
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110,USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
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41
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Swanson MR, Shen MD, Wolff JJ, Boyd B, Clements M, Rehg J, Elison JT, Paterson S, Parish-Morris J, Chappell JC, Hazlett HC, Emerson RW, Botteron K, Pandey J, Schultz RT, Dager SR, Zwaigenbaum L, Estes AM, Piven J. Naturalistic Language Recordings Reveal "Hypervocal" Infants at High Familial Risk for Autism. Child Dev 2017; 89:e60-e73. [PMID: 28295208 DOI: 10.1111/cdev.12777] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Children's early language environments are related to later development. Little is known about this association in siblings of children with autism spectrum disorder (ASD), who often experience language delays or have ASD. Fifty-nine 9-month-old infants at high or low familial risk for ASD contributed full-day in-home language recordings. High-risk infants produced more vocalizations than low-risk peers; conversational turns and adult words did not differ by group. Vocalization differences were driven by a subgroup of "hypervocal" infants. Despite more vocalizations overall, these infants engaged in less social babbling during a standardized clinic assessment, and they experienced fewer conversational turns relative to their rate of vocalizations. Two ways in which these individual and environmental differences may relate to subsequent development are discussed.
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Affiliation(s)
| | | | | | - Brian Boyd
- University of North Carolina at Chapel Hill
| | | | | | | | - Sarah Paterson
- Temple University.,The Children's Hospital of Philadelphia
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42
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Wolff JJ, Swanson MR, Elison JT, Gerig G, Pruett JR, Styner MA, Vachet C, Botteron KN, Dager SR, Estes AM, Hazlett HC, Schultz RT, Shen MD, Zwaigenbaum L, Piven J. Neural circuitry at age 6 months associated with later repetitive behavior and sensory responsiveness in autism. Mol Autism 2017; 8:8. [PMID: 28316772 PMCID: PMC5351210 DOI: 10.1186/s13229-017-0126-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/25/2017] [Indexed: 01/10/2023] Open
Abstract
Background Restricted and repetitive behaviors are defining features of autism spectrum disorder (ASD). Under revised diagnostic criteria for ASD, this behavioral domain now includes atypical responses to sensory stimuli. To date, little is known about the neural circuitry underlying these features of ASD early in life. Methods Longitudinal diffusion tensor imaging data were collected from 217 infants at high familial risk for ASD. Forty-four of these infants were diagnosed with ASD at age 2. Targeted cortical, cerebellar, and striatal white matter pathways were defined and measured at ages 6, 12, and 24 months. Dependent variables included the Repetitive Behavior Scale-Revised and the Sensory Experiences Questionnaire. Results Among children diagnosed with ASD, repetitive behaviors and sensory response patterns were strongly correlated, even when accounting for developmental level or social impairment. Longitudinal analyses indicated that the genu and cerebellar pathways were significantly associated with both repetitive behaviors and sensory responsiveness but not social deficits. At age 6 months, fractional anisotropy in the genu significantly predicted repetitive behaviors and sensory responsiveness at age 2. Cerebellar pathways significantly predicted later sensory responsiveness. Exploratory analyses suggested a possible disordinal interaction based on diagnostic status for the association between fractional anisotropy and repetitive behavior. Conclusions Our findings suggest that restricted and repetitive behaviors contributing to a diagnosis of ASD at age 2 years are associated with structural properties of callosal and cerebellar white matter pathways measured during infancy and toddlerhood. We further identified that repetitive behaviors and unusual sensory response patterns co-occur and share common brain-behavior relationships. These results were strikingly specific given the absence of association between targeted pathways and social deficits. Electronic supplementary material The online version of this article (doi:10.1186/s13229-017-0126-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN USA
| | - Meghan R Swanson
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN USA
| | - Guido Gerig
- Tandon School of Engineering, New York University, New York City, NY USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Martin A Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Clement Vachet
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA USA
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA USA
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC USA.,Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC USA
| | | | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC USA.,Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
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St John T, Estes AM, Dager SR, Kostopoulos P, Wolff JJ, Pandey J, Elison JT, Paterson SJ, Schultz RT, Botteron K, Hazlett H, Piven J. Emerging Executive Functioning and Motor Development in Infants at High and Low Risk for Autism Spectrum Disorder. Front Psychol 2016; 7:1016. [PMID: 27458411 PMCID: PMC4932099 DOI: 10.3389/fpsyg.2016.01016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 06/21/2016] [Indexed: 11/13/2022] Open
Abstract
Existing evidence suggests executive functioning (EF) deficits may be present in children with autism spectrum disorder (ASD) by 3 years of age. It is less clear when, prior to 3 years, EF deficits may emerge and how EF unfold over time. The contribution of motor skill difficulties to poorer EF in children with ASD has not been systematically studied. We investigated the developmental trajectory of EF in infants at high and low familial risk for ASD (HR and LR) and the potential associations between motor skills, diagnostic group, and EF performance. Participants included 186 HR and 76 LR infants. EF (A-not-B), motor skills (Fine and Gross Motor), and cognitive ability were directly assessed at 12 months and 24 months of age. Participants were directly evaluated for ASD at 24 months using DSM-IV-TR criteria and categorized as HR-ASD, HR-Negative, and LR-Negative. HR-ASD and HR-Negative siblings demonstrated less improvement in EF over time compared to the LR-Negative group. Motor skills were associated with group and EF performance at 12 months. No group differences were found at 12 months, but at 24 months, the HR-ASD and HR-Negative groups performed worse than the LR-Negative group overall after controlling for visual reception and maternal education. On reversal trials, the HR-ASD group performed worse than the LR-Negative group. Motor skills were associated with group and EF performance on reversal trials at 24 months. Findings suggest that HR siblings demonstrate altered EF development and that motor skills may play an important role in this process.
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Affiliation(s)
- Tanya St John
- Speech and Hearing Sciences, University of WashingtonSeattle, WA, USA; UW Autism Center, Center on Human Development and Disability, University of WashingtonSeattle, WA, USA
| | - Annette M Estes
- Speech and Hearing Sciences, University of WashingtonSeattle, WA, USA; UW Autism Center, Center on Human Development and Disability, University of WashingtonSeattle, WA, USA
| | - Stephen R Dager
- UW Autism Center, Center on Human Development and Disability, University of WashingtonSeattle, WA, USA; Department of Radiology, University of WashingtonSeattle, WA, USA
| | - Penelope Kostopoulos
- McConnell Brain Imaging Centre, Montreal Neurological Institute Montreal, CA, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota Minneapolis, MN, USA
| | - Juhi Pandey
- Department of Pediatrics, The Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Philadelphia, PA, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota Minneapolis, MN, USA
| | - Sarah J Paterson
- Department of Pediatrics, The Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Philadelphia, PA, USA
| | - Robert T Schultz
- Department of Pediatrics, The Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Philadelphia, PA, USA
| | - Kelly Botteron
- Department of Psychiatry, Washington University School of Medicine Saint Louis, MO, USA
| | - Heather Hazlett
- Carolina Institute for Developmental DisabilitiesChapel Hill, NC, USA; Department of Psychiatry, University of North CarolinaChapel Hill, NC
| | - Joseph Piven
- Carolina Institute for Developmental DisabilitiesChapel Hill, NC, USA; Department of Psychiatry, University of North CarolinaChapel Hill, NC
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44
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Wolff JJ, Gerig G, Lewis JD, Soda T, Styner MA, Vachet C, Botteron KN, Elison JT, Dager SR, Estes AM, Hazlett HC, Schultz RT, Zwaigenbaum L, Piven J. Altered corpus callosum morphology associated with autism over the first 2 years of life. Brain 2015; 138:2046-58. [PMID: 25937563 DOI: 10.1093/brain/awv118] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/06/2015] [Indexed: 11/13/2022] Open
Abstract
Numerous brain imaging studies indicate that the corpus callosum is smaller in older children and adults with autism spectrum disorder. However, there are no published studies examining the morphological development of this connective pathway in infants at-risk for the disorder. Magnetic resonance imaging data were collected from 270 infants at high familial risk for autism spectrum disorder and 108 low-risk controls at 6, 12 and 24 months of age, with 83% of infants contributing two or more data points. Fifty-seven children met criteria for ASD based on clinical-best estimate diagnosis at age 2 years. Corpora callosa were measured for area, length and thickness by automated segmentation. We found significantly increased corpus callosum area and thickness in children with autism spectrum disorder starting at 6 months of age. These differences were particularly robust in the anterior corpus callosum at the 6 and 12 month time points. Regression analysis indicated that radial diffusivity in this region, measured by diffusion tensor imaging, inversely predicted thickness. Measures of area and thickness in the first year of life were correlated with repetitive behaviours at age 2 years. In contrast to work from older children and adults, our findings suggest that the corpus callosum may be larger in infants who go on to develop autism spectrum disorder. This result was apparent with or without adjustment for total brain volume. Although we did not see a significant interaction between group and age, cross-sectional data indicated that area and thickness differences diminish by age 2 years. Regression data incorporating diffusion tensor imaging suggest that microstructural properties of callosal white matter, which includes myelination and axon composition, may explain group differences in morphology.
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Affiliation(s)
- Jason J Wolff
- 1 Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Guido Gerig
- 2 Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - John D Lewis
- 3 Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Takahiro Soda
- 4 Health Sciences and Technology, Harvard Medical School and Massachusetts Institute of Technology, Boston, MA, USA 5 Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Martin A Styner
- 5 Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 6 Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Clement Vachet
- 2 Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Kelly N Botteron
- 7 Department of Psychiatry, Washington University at St. Louis, St. Louis, MO, USA
| | - Jed T Elison
- 8 Institute for Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Stephen R Dager
- 9 Department of Radiology, University of Washington, Seattle, WA, USA
| | - Annette M Estes
- 10 Department of Speech and Hearing Science, University of Washington, Seattle, WA, USA
| | - Heather C Hazlett
- 5 Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 6 Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert T Schultz
- 11 Centre for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lonnie Zwaigenbaum
- 12 Department of Paediatrics, University of Alberta, Edmonton AB, Canada
| | - Joseph Piven
- 5 Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 6 Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Pruett JR, Kandala S, Hoertel S, Snyder AZ, Elison JT, Nishino T, Feczko E, Dosenbach NUF, Nardos B, Power JD, Adeyemo B, Botteron KN, McKinstry RC, Evans AC, Hazlett HC, Dager SR, Paterson S, Schultz RT, Collins DL, Fonov VS, Styner M, Gerig G, Das S, Kostopoulos P, Constantino JN, Estes AM, Petersen SE, Schlaggar BL, Piven J. Accurate age classification of 6 and 12 month-old infants based on resting-state functional connectivity magnetic resonance imaging data. Dev Cogn Neurosci 2015; 12:123-33. [PMID: 25704288 PMCID: PMC4385423 DOI: 10.1016/j.dcn.2015.01.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 11/29/2022] Open
Abstract
SVMs classified 6 versus 12 month-old infants above chance based on fcMRI data alone. We carefully accounted for the effects of fcMRI motion artifact. These results coincide with a period of dramatic change in infant development. Two interpretations about connections supporting this age categorization are given.
Human large-scale functional brain networks are hypothesized to undergo significant changes over development. Little is known about these functional architectural changes, particularly during the second half of the first year of life. We used multivariate pattern classification of resting-state functional connectivity magnetic resonance imaging (fcMRI) data obtained in an on-going, multi-site, longitudinal study of brain and behavioral development to explore whether fcMRI data contained information sufficient to classify infant age. Analyses carefully account for the effects of fcMRI motion artifact. Support vector machines (SVMs) classified 6 versus 12 month-old infants (128 datasets) above chance based on fcMRI data alone. Results demonstrate significant changes in measures of brain functional organization that coincide with a special period of dramatic change in infant motor, cognitive, and social development. Explorations of the most different correlations used for SVM lead to two different interpretations about functional connections that support 6 versus 12-month age categorization.
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Affiliation(s)
- John R Pruett
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Sridhar Kandala
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Sarah Hoertel
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Abraham Z Snyder
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Jed T Elison
- University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, United States.
| | - Tomoyuki Nishino
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Eric Feczko
- Emory University, 201 Dowman Drive, Atlanta, GA 30322, United States.
| | - Nico U F Dosenbach
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Binyam Nardos
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Jonathan D Power
- National Institute of Mental Health, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, United States.
| | - Babatunde Adeyemo
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Kelly N Botteron
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Robert C McKinstry
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Alan C Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC, Canada H3A 2B4.
| | - Heather C Hazlett
- University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, United States.
| | - Stephen R Dager
- University of Washington, Seattle, 1410 NE Campus Parkway, Seattle, WA 98195, United States.
| | - Sarah Paterson
- Children's Hospital of Philadelphia and University of Pennsylvania, Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Robert T Schultz
- Children's Hospital of Philadelphia and University of Pennsylvania, Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC, Canada H3A 2B4.
| | - Vladimir S Fonov
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC, Canada H3A 2B4.
| | - Martin Styner
- University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, United States.
| | - Guido Gerig
- University of Utah, Salt Lake City, 201 Presidents Circle, Salt Lake City, UT 84112, United States.
| | - Samir Das
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC, Canada H3A 2B4.
| | - Penelope Kostopoulos
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC, Canada H3A 2B4.
| | - John N Constantino
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Annette M Estes
- University of Washington, Seattle, 1410 NE Campus Parkway, Seattle, WA 98195, United States.
| | | | - Steven E Petersen
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Bradley L Schlaggar
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - Joseph Piven
- University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, United States.
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Elison JT, Wolff JJ, Reznick JS, Botteron KN, Estes AM, Gu H, Hazlett HC, Meadows AJ, Paterson SJ, Zwaigenbaum L, Piven J. Repetitive behavior in 12-month-olds later classified with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry 2014; 53:1216-24. [PMID: 25440311 PMCID: PMC4254502 DOI: 10.1016/j.jaac.2014.08.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 07/18/2014] [Accepted: 08/29/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE As compared to the utility of early emerging social communicative risk markers for predicting a later diagnosis of autism spectrum disorder (ASD), less is known about the relevance of early patterns of restricted and repetitive behaviors. We examined patterns of stereotyped motor mannerisms and repetitive manipulation of objects in 12-month-olds at high and low risk for developing ASD, all of whom were assessed for ASD at 24 months. METHOD Observational coding of repetitive object manipulation and stereotyped motor behaviors in digital recordings of the Communication and Symbolic Behavior Scales was conducted using the Repetitive and Stereotyped Movement Scales for 3 groups of 12-month-olds: low-risk infants (LR, n = 53); high-familial-risk infants who did not meet diagnostic criteria for ASD at 24 months (HR-negative, n = 75); and high-familial-risk infants who met diagnostic criteria for ASD at 24 months (HR-ASD, n = 30). RESULTS The HR-ASD group showed significantly more stereotyped motor mannerisms than both the HR-negative group (p = .025) and the LR group (p = .001). The HR-ASD and HR-negative groups demonstrated statistically equivalent repetitive object manipulation scores (p = .431), and both groups showed significantly more repetitive object manipulation than the LR group (p < .040). Combining the motor and object stereotypy scores into a Repetitive and Stereotyped Movement Scales (RSMS) composite yielded a disorder-continuum effect such that each group was significantly different from one another (LR < HR-negative < HR-ASD). CONCLUSION These results suggest that targeted assessment of repetitive behavior during infancy may augment early ASD identification efforts.
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Wolff JJ, Botteron KN, Dager SR, Elison JT, Estes AM, Gu H, Hazlett HC, Pandey J, Paterson SJ, Schultz RT, Zwaigenbaum L, Piven J. Longitudinal patterns of repetitive behavior in toddlers with autism. J Child Psychol Psychiatry 2014; 55:945-53. [PMID: 24552513 PMCID: PMC4107191 DOI: 10.1111/jcpp.12207] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Recent evidence suggests that restricted and repetitive behaviors may differentiate children who develop autism spectrum disorder (ASD) by late infancy. How these core symptoms manifest early in life, particularly among infants at high risk for the disorder, is not well characterized. METHODS Prospective, longitudinal parent-report data (Repetitive Behavior Scales-Revised) were collected for 190 high-risk toddlers and 60 low-risk controls from 12 to 24 months of age. Forty-one high-risk children were classified with ASD at age 2. Profiles of repetitive behavior were compared between groups using generalized estimating equations. RESULTS Longitudinal profiles for children diagnosed with ASD differed significantly from high- and low-risk children without the disorder on all measures of repetitive behavior. High-risk toddlers without ASD were intermediate to low risk and ASD positive counterparts. Toddlers with ASD showed significantly higher rates of repetitive behavior across subtypes at the 12-month time point. Repetitive behaviors were significantly correlated with adaptive behavior and socialization scores among children with ASD at 24 months of age, but were largely unrelated to measures of general cognitive ability. CONCLUSIONS These findings suggest that as early as 12 months of age, a broad range of repetitive behaviors are highly elevated in children who go on to develop ASD. While some degree of repetitive behavior is elemental to typical early development, the extent of these behaviors among children who develop ASD appears highly atypical.
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Affiliation(s)
- Jason J Wolff
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Corrigan NM, Shaw DWW, Estes AM, Richards TL, Munson J, Friedman SD, Dawson G, Artru AA, Dager SR. Atypical developmental patterns of brain chemistry in children with autism spectrum disorder. JAMA Psychiatry 2013; 70:964-74. [PMID: 23903694 DOI: 10.1001/jamapsychiatry.2013.1388] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Autism spectrum disorder (ASD) is a neurodevelopmental disorder with symptoms emerging during early childhood. The pathophysiology underlying the disorder remains incompletely understood. OBJECTIVE To examine cross-sectional and longitudinal patterns of brain chemical concentrations in children with ASD or idiopathic developmental delay (DD) from 3 different age points, beginning early in the clinical course. DESIGN Proton magnetic resonance spectroscopic imaging data were acquired longitudinally for children with ASD or DD, and primarily cross-sectionally for children with typical development (TD), at 3 to 4, 6 to 7, and 9 to 10 years of age. SETTING Recruitment, diagnostic assessments, and magnetic resonance imaging were performed at the University of Washington in Seattle. PARTICIPANTS Seventy-three children (45 with ASD, 14 with DD, and 14 with TD) at 3 to 4 years of age; 69 children (35 with ASD, 14 with DD, and 20 with TD) at 6 to 7 years of age; and 77 children (29 with ASD, 15 with DD, and 33 with TD) at 9 to 10 years of age. MAIN OUTCOMES AND MEASURES Concentrations of N-acetylaspartate (NAA), choline (Cho), creatine (Cr), myo-inositol (mI), and glutamine plus glutamate (Glx) in cerebral gray matter (GM) and white matter (WM) at 3 to 4, 6 to 7, and 9 to 10 years of age, and calculation of rates of change of these chemicals between 3 and 10 years of age. RESULTS At 3 to 4 years of age, the ASD group exhibited lower NAA, Cho, and Cr concentrations than did the TD group in both GM and WM, alterations that largely were not observed at 9 to 10 years of age. The DD group exhibited reduced GM and WM NAA concentrations at 3 to 4 years of age; GM NAA concentrations remained reduced at 9 to 10 years of age compared with the TD group. There were distinct differences between the ASD and DD groups in the rates of GM NAA, Cho, and Cr changes between 3 and 10 years of age. CONCLUSIONS AND RELEVANCE The GM chemical changes between 3 and 10 years of age differentiated the children with ASD from those with DD. Most notably, a dynamic reversal of GM NAA reductions was observed in the children with ASD. By contrast, persistent GM NAA reductions in the children with DD suggest a different, more static, underlying developmental process.
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Elison JT, Paterson SJ, Wolff JJ, Reznick JS, Sasson NJ, Gu H, Botteron KN, Dager SR, Estes AM, Evans AC, Gerig G, Hazlett HC, Schultz RT, Styner M, Zwaigenbaum L, Piven J. White matter microstructure and atypical visual orienting in 7-month-olds at risk for autism. Am J Psychiatry 2013; 170:899-908. [PMID: 23511344 PMCID: PMC3863364 DOI: 10.1176/appi.ajp.2012.12091150] [Citation(s) in RCA: 207] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to determine whether specific patterns of oculomotor functioning and visual orienting characterize 7-month-old infants who later meet criteria for an autism spectrum disorder (ASD) and to identify the neural correlates of these behaviors. METHOD Data were collected from 97 infants, of whom 16 were high-familial-risk infants later classified as having an ASD, 40 were high-familial-risk infants who did not later meet ASD criteria (high-risk negative), and 41 were low-risk infants. All infants underwent an eye-tracking task at a mean age of 7 months and a clinical assessment at a mean age of 25 months. Diffusion-weighted imaging data were acquired for 84 of the infants at 7 months. Primary outcome measures included average saccadic reaction time in a visually guided saccade procedure and radial diffusivity (an index of white matter organization) in fiber tracts that included corticospinal pathways and the splenium and genu of the corpus callosum. RESULTS Visual orienting latencies were longer in 7-month-old infants who expressed ASD symptoms at 25 months compared with both high-risk negative infants and low-risk infants. Visual orienting latencies were uniquely associated with the microstructural organization of the splenium of the corpus callosum in low-risk infants, but this association was not apparent in infants later classified as having an ASD. CONCLUSIONS Flexibly and efficiently orienting to salient information in the environment is critical for subsequent cognitive and social-cognitive development. Atypical visual orienting may represent an early prodromal feature of an ASD, and abnormal functional specialization of posterior cortical circuits directly informs a novel model of ASD pathogenesis.
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Fatemi SH, Aldinger KA, Ashwood P, Bauman ML, Blaha CD, Blatt GJ, Chauhan A, Chauhan V, Dager SR, Dickson PE, Estes AM, Goldowitz D, Heck DH, Kemper TL, King BH, Martin LA, Millen KJ, Mittleman G, Mosconi MW, Persico AM, Sweeney JA, Webb SJ, Welsh JP. Consensus paper: pathological role of the cerebellum in autism. Cerebellum 2012; 11:777-807. [PMID: 22370873 PMCID: PMC3677555 DOI: 10.1007/s12311-012-0355-9] [Citation(s) in RCA: 444] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
There has been significant advancement in various aspects of scientific knowledge concerning the role of cerebellum in the etiopathogenesis of autism. In the current consensus paper, we will observe the diversity of opinions regarding the involvement of this important site in the pathology of autism. Recent emergent findings in literature related to cerebellar involvement in autism are discussed, including: cerebellar pathology, cerebellar imaging and symptom expression in autism, cerebellar genetics, cerebellar immune function, oxidative stress and mitochondrial dysfunction, GABAergic and glutamatergic systems, cholinergic, dopaminergic, serotonergic, and oxytocin-related changes in autism, motor control and cognitive deficits, cerebellar coordination of movements and cognition, gene-environment interactions, therapeutics in autism, and relevant animal models of autism. Points of consensus include presence of abnormal cerebellar anatomy, abnormal neurotransmitter systems, oxidative stress, cerebellar motor and cognitive deficits, and neuroinflammation in subjects with autism. Undefined areas or areas requiring further investigation include lack of treatment options for core symptoms of autism, vermal hypoplasia, and other vermal abnormalities as a consistent feature of autism, mechanisms underlying cerebellar contributions to cognition, and unknown mechanisms underlying neuroinflammation.
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Affiliation(s)
- S Hossein Fatemi
- University of Minnesota Medical School, 420 Delaware St. SE, Minneapolis, MN 55455, USA.
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