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Cremone-Caira A, Braverman Y, MacNaughton GA, Nikolaeva JI, Faja S. Reduced Visual Evoked Potential Amplitude in Autistic Children with Co-Occurring Features of Attention-Deficit/Hyperactivity Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06005-7. [PMID: 37249694 DOI: 10.1007/s10803-023-06005-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 05/31/2023]
Abstract
Provided the significant overlap in features of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), there is a critical need to identify transdiagnostic markers that could meaningfully stratify subgroups. The objective of this study was to compare the visual evoked potential (VEP) between 30 autistic children, 17 autistic children with co-occurring ADHD presentation (ASD + ADHD), and 21 neurotypical children (NTC). Electroencephalography was recorded while children passively viewed a pattern-reversal stimulus. Mean amplitude of the P1 event-related potential was extracted from a midline occipital channel and compared between groups. P1 mean amplitude was reduced in the ASD + ADHD group compared to the ASD and NTC groups, indicating a distinct pattern of brain activity in autistic children with co-occurring ADHD features.
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Affiliation(s)
- Amanda Cremone-Caira
- Department of Psychology, Assumption University, Worcester, USA
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 2 Brookline Place, Brookline, MA, 02445, USA
| | - Yael Braverman
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 2 Brookline Place, Brookline, MA, 02445, USA
- Department of Neurology, Boston Children's Hospital, Boston, USA
| | | | - Julia I Nikolaeva
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, USA
| | - Susan Faja
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, 2 Brookline Place, Brookline, MA, 02445, USA.
- Department of Neurology, Boston Children's Hospital, Boston, USA.
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Faja S, Sabatos-DeVito M, Sridhar A, Kuhn JL, Nikolaeva JI, Sugar CA, Webb SJ, Bernier RA, Sikich L, Hellemann G, Senturk D, Naples AJ, Shic F, Levin AR, Seow HA, Dziura JD, Jeste SS, Chawarska K, Nelson CA, Dawson G, McPartland JC. Evaluation of clinical assessments of social abilities for use in autism clinical trials by the autism biomarkers consortium for clinical trials. Autism Res 2023; 16:981-996. [PMID: 36929131 PMCID: PMC10192100 DOI: 10.1002/aur.2905] [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: 10/20/2022] [Accepted: 02/11/2023] [Indexed: 03/18/2023]
Abstract
Clinical trials in autism spectrum disorder (ASD) often rely on clinician rating scales and parent surveys to measure autism-related features and social behaviors. To aid in the selection of these assessments for future clinical trials, the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) directly compared eight common instruments with respect to acquisition rates, sensitivity to group differences, equivalence across demographic sub-groups, convergent validity, and stability over a 6-week period. The sample included 280 children diagnosed with ASD (65 girls) and 119 neurotypical children (36 girls) aged from 6 to 11 years. Full scale IQ for ASD ranged from 60 to 150 and for neurotypical ranged from 86 to 150. Instruments measured clinician global assessment and autism-related behaviors, social communication abilities, adaptive function, and social withdrawal behavior. For each instrument, we examined only the scales that measured social or communication functioning. Data acquisition rates were at least 97.5% at T1 and 95.7% at T2. All scales distinguished diagnostic groups. Some scales significantly differed by participant and/or family demographic characteristics. Within the ASD group, most clinical instruments exhibited weak (≥ |0.1|) to moderate (≥ |0.4|) intercorrelations. Short-term stability was moderate (ICC: 0.5-0.75) to excellent (ICC: >0.9) within the ASD group. Variations in the degree of stability may inform viability for different contexts of use, such as identifying clinical subgroups for trials versus serving as a modifiable clinical outcome. All instruments were evaluated in terms of their advantages and potential concerns for use in clinical trials.
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Affiliation(s)
- Susan Faja
- Department of Pediatrics, Harvard Medical School. Boston MA. USA
- Boston Children’s Hospital. Boston MA. USA
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University. Durham NC. USA
- Department of Psychiatry & Behavioral Sciences, Duke University. Durham NC. USA
| | | | - Jocelyn L. Kuhn
- Department of Pediatrics, Boston University School of Medicine. Boston MA. USA
| | - Julia I. Nikolaeva
- Department of Communication Sciences and Disorders, Northwestern University. Evanston IL. USA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los Angeles. Los Angeles CA. USA
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles. Los Angeles CA. USA
| | - Sara Jane Webb
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute. Seattle WA. USA
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine. Seattle WA. USA
| | - Raphael A. Bernier
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine. Seattle WA. USA
| | - Linmarie Sikich
- Department of Psychiatry & Behavioral Sciences, Duke University. Durham NC. USA
| | - Gerhard Hellemann
- Department of Biostatistics, University of Alabama at Birmingham. Birmingham AB. USA
| | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles. Los Angeles CA. USA
| | - Adam J. Naples
- Yale Child Study Center, Yale University. New Haven CT. USA
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute. Seattle WA. USA
- Department of General Pediatrics, University of Washington School of Medicine. Seattle WA. USA
| | - April R. Levin
- Department of Neurology, Boston Children’s Hospital. Boston MA. USA
- Harvard Medical School. Boston MA. USA
| | - Helen A. Seow
- Yale Center for Clinical Investigation, Yale University. New Haven CT. USA
| | - James D. Dziura
- Department of Emergency Medicine, Yale University. New Haven CT. USA
| | - Shafali S. Jeste
- Department of Pediatrics and Neurology, Children’s Hospital, Los Angeles. Los Angeles CA. USA
- USC Keck School of Medicine. Los Angeles CA. USA
| | | | - Charles A. Nelson
- Department of Pediatrics, Harvard Medical School. Boston MA. USA
- Boston Children’s Hospital. Boston MA. USA
- Graduate School of Education, Harvard University. Boston MA. USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University. Durham NC. USA
- Department of Psychiatry & Behavioral Sciences, Duke University. Durham NC. USA
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Sridhar A, Kuhn J, Faja S, Sabatos-DeVito M, Nikolaeva JI, Dawson G, Nelson CA, Webb SJ, Bernier R, Jeste S, Chawarska K, Sugar CA, Shic F, Naples A, Dziura J, McPartland JC. Patterns of Intervention Utilization Among School-Aged Children with Autism Spectrum Disorder: Findings from a Multi-Site Research Consortium. Res Autism Spectr Disord 2022; 94. [PMID: 35444715 PMCID: PMC9015686 DOI: 10.1016/j.rasd.2022.101950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
When designing and interpreting results from clinical trials evaluating treatments for children on the autism spectrum, a complicating factor is that most children receive a range of concurrent treatments. Thus, it is important to better understand the types and hours of interventions that participants typically receive as part of standard of care, as well as to understand the child, family, and geographic factors that are associated with different patterns of service utilization. In this multi-site study, we interviewed 280 caregivers of 6-to-11-year-old school-aged children on the autism spectrum about the types and amounts of interventions their children received in the prior 6 weeks. Reported interventions were coded as "evidence-based practice" or "other interventions," reflecting the level of empirical support. Results indicated that children received a variety of interventions with varying levels of empirical evidence and a wide range of hours (0 to 79.3 hours/week). Children with higher autism symptom levels, living in particular states, and who identified as non-Hispanic received more evidence-based intervention hours. Higher parental education level related to more hours of other interventions. Children who were younger, had lower cognitive ability, and with higher autism symptom levels received a greater variety of interventions overall. Thus, based on our findings, it would seem prudent when designing clinical trials to take into consideration a variety of factors including autism symptom levels, age, cognitive ability, ethnicity, parent education and geographic location. Future research should continue to investigate the ethnic, racial, and socioeconomic influences on school-aged intervention services.
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Affiliation(s)
- Aksheya Sridhar
- Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Susan Faja
- Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | | | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - Charles A Nelson
- Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | - Sara J Webb
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle WA, USA
| | - Raphael Bernier
- Department of Pediatrics, University of Washington School of Medicine, Seattle WA, USA
| | | | | | | | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle WA, USA
| | | | - James Dziura
- Yale Center for Analytical Sciences, New Haven, CT USA
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Norton ES, Manning BL, Harriott EM, Nikolaeva JI, Nyabingi OS, Fredian KM, Page JM, McWeeny S, Krogh-Jespersen S, MacNeill LA, Roberts MY, Wakschlag LS. Social EEG: A novel neurodevelopmental approach to studying brain-behavior links and brain-to-brain synchrony during naturalistic toddler-parent interactions. Dev Psychobiol 2022; 64:e22240. [PMID: 35312062 PMCID: PMC9867891 DOI: 10.1002/dev.22240] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 01/26/2023]
Abstract
Despite increasing emphasis on emergent brain-behavior patterns supporting language, cognitive, and socioemotional development in toddlerhood, methodologic challenges impede their characterization. Toddlers are notoriously difficult to engage in brain research, leaving a developmental window in which neural processes are understudied. Further, electroencephalography (EEG) and event-related potential paradigms at this age typically employ structured, experimental tasks that rarely reflect formative naturalistic interactions with caregivers. Here, we introduce and provide proof of concept for a new "Social EEG" paradigm, in which parent-toddler dyads interact naturally during EEG recording. Parents and toddlers sit at a table together and engage in different activities, such as book sharing or watching a movie. EEG is time locked to the video recording of their interaction. Offline, behavioral data are microcoded with mutually exclusive engagement state codes. From 216 sessions to date with 2- and 3-year-old toddlers and their parents, 72% of dyads successfully completed the full Social EEG paradigm, suggesting that it is possible to collect dual EEG from parents and toddlers during naturalistic interactions. In addition to providing naturalistic information about child neural development within the caregiving context, this paradigm holds promise for examination of emerging constructs such as brain-to-brain synchrony in parents and children.
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Affiliation(s)
- Elizabeth S. Norton
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Brittany L. Manning
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Emily M. Harriott
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Julia I. Nikolaeva
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Olufemi S. Nyabingi
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Kaitlyn M. Fredian
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Jessica M. Page
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Sean McWeeny
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Leigha A. MacNeill
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Megan Y. Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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