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Goez H, Nielsen CC, Bryan S, Clark B, Zwaigenbaum L, Yamamoto SS, Osornio-Vargas AR. Autistic Regression and Exposure to Industrial Chemicals: Preliminary Observations. Can J Neurol Sci 2024; 51:289-292. [PMID: 37519226 DOI: 10.1017/cjn.2023.265] [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] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Exposure to industrial pollutants is a potential risk factor not fully explored in ASD with regression (ASD+R). We studied geographical collocation patterns of industrial air chemical emissions and the location of homes of children with ASD+R at different exposure times, compared with ASD cases without regression (ASD-R). Fifteen of 111 emitted chemicals collocated with ASD+R, and 65 with ASD-R. ASD+R collocated more strongly with different neurotoxicants/immunotoxicants a year before diagnosis, whereas ASD-R were moderately collocated with chemicals across all exposure periods. This preliminary exploratory analysis of differences in exposure patterns raises a question regarding potential pathophysiological differences between the conditions.
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Affiliation(s)
- Helly Goez
- Division of Developmental Medicine and Rehabilitation, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | | | - Sean Bryan
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Brenda Clark
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | | | - Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Alvaro R Osornio-Vargas
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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2
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McFayden TC, Rutsohn J, Cetin G, Forsen E, Swanson MR, Meera SS, Wolff JJ, Elison JT, Shen MD, Botteron K, Dager SR, Estes A, Gerig G, McKinstry RC, Pandey J, Schultz R, St John T, Styner M, Truong Y, Zwaigenbaum L, Hazlett HC, Piven J, Girault JB. White matter development and language abilities during infancy in autism spectrum disorder. Mol Psychiatry 2024:10.1038/s41380-024-02470-3. [PMID: 38383768 DOI: 10.1038/s41380-024-02470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/23/2024]
Abstract
White matter (WM) fiber tract differences are present in autism spectrum disorder (ASD) and could be important markers of behavior. One of the earliest phenotypic differences in ASD are language atypicalities. Although language has been linked to WM in typical development, no work has evaluated this association in early ASD. Participants came from the Infant Brain Imaging Study and included 321 infant siblings of children with ASD at high likelihood (HL) for developing ASD; 70 HL infants were later diagnosed with ASD (HL-ASD), and 251 HL infants were not diagnosed with ASD (HL-Neg). A control sample of 140 low likelihood infants not diagnosed with ASD (LL-Neg) were also included. Infants contributed expressive language, receptive language, and diffusion tensor imaging data at 6-, 12-, and 24 months. Mixed effects regression models were conducted to evaluate associations between WM and language trajectories. Trajectories of microstructural changes in the right arcuate fasciculus were associated with expressive language development. HL-ASD infants demonstrated a different developmental pattern compared to the HL-Neg and LL-Neg groups, wherein the HL-ASD group exhibited a positive association between WM fractional anisotropy and language whereas HL-Neg and LL-Neg groups showed weak or no association. No other fiber tracts demonstrated significant associations with language. In conclusion, results indicated arcuate fasciculus WM is linked to language in early toddlerhood for autistic toddlers, with the strongest associations emerging around 24 months. To our knowledge, this is the first study to evaluate associations between language and WM development during the pre-symptomatic period in ASD.
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Affiliation(s)
- Tyler C McFayden
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA.
| | - Joshua Rutsohn
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gizem Cetin
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Elizabeth Forsen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Meghan R Swanson
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Shoba S Meera
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Kelly 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
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
| | - Annette Estes
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Guido Gerig
- Tandon School of Engineering, New York University, New York, NY, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Juhi Pandey
- Center for Autism Research, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Schultz
- Center for Autism Research, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Tanya St John
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Young Truong
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
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3
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Marrus N, Botteron KN, Hawks Z, Pruett JR, Elison JT, Jackson JJ, Markson L, Eggebrecht AT, Burrows CA, Zwaigenbaum L, Dager S, Estes A, Hazlett H, Schultz RT, Piven J, Constantino JN. Social motivation in infancy is associated with familial recurrence of ASD. Dev Psychopathol 2024; 36:101-111. [PMID: 36189644 PMCID: PMC10067534 DOI: 10.1017/s0954579422001006] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Pre-diagnostic deficits in social motivation are hypothesized to contribute to autism spectrum disorder (ASD), a heritable neurodevelopmental condition. We evaluated psychometric properties of a social motivation index (SMI) using parent-report item-level data from 597 participants in a prospective cohort of infant siblings at high and low familial risk for ASD. We tested whether lower SMI scores at 6, 12, and 24 months were associated with a 24-month ASD diagnosis and whether social motivation's course differed relative to familial ASD liability. The SMI displayed good internal consistency and temporal stability. Children diagnosed with ASD displayed lower mean SMI T-scores at all ages and a decrease in mean T-scores across age. Lower group-level 6-month scores corresponded with higher familial ASD liability. Among high-risk infants, strong decline in SMI T-scores was associated with 10-fold odds of diagnosis. Infant social motivation is quantifiable by parental report, differentiates children with versus without later ASD by age 6 months, and tracks with familial ASD liability, consistent with a diagnostic and susceptibility marker of ASD. Early decrements and decline in social motivation indicate increased likelihood of ASD, highlighting social motivation's importance to risk assessment and clarification of the ontogeny of ASD.
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Affiliation(s)
- Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine
| | | | - Zoë Hawks
- Department of Psychological & Brain Sciences, Washington University in St. Louis
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota
| | - Joshua J. Jackson
- Department of Psychological & Brain Sciences, Washington University in St. Louis
| | - Lori Markson
- Department of Psychological & Brain Sciences, Washington University in St. Louis
| | - Adam T. Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine
| | | | | | | | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington
| | - Heather Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | | | - Joseph Piven
- Department of Psychiatry, University of North Carolina at Chapel Hill
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4
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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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Sacrey LAR, Zwaigenbaum L, Brian JA, Smith IM, Armstrong V, Vaillancourt T, Schmidt LA. Behavioral and physiological differences during an emotion-evoking task in children at increased likelihood for autism spectrum disorder. Dev Psychopathol 2024; 36:404-414. [PMID: 36573373 DOI: 10.1017/s0954579422001286] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Literature examining emotional regulation in infants with autism spectrum disorder (ASD) has focused on parent report. We examined behavioral and physiological responses during an emotion-evoking task designed to elicit emotional states in infants. Infants at an increased likelihood for ASD (IL; have an older sibling with ASD; 96 not classified; 29 classified with ASD at age two) and low likelihood (LL; no family history of ASD; n = 61) completed the task at 6, 12, and 18 months. The main findings were (1) the IL-ASD group displayed higher levels of negative affect during toy removal and negative tasks compared to the IL non-ASD and LL groups, respectively, (2) the IL-ASD group spent more time looking at the baseline task compared to the other two groups, and (3) the IL-ASD group showed a greater increase in heart rate from baseline during the toy removal and negative tasks compared to the LL group. These results suggest that IL children who are classified as ASD at 24 months show differences in affect, gaze, and heart rate during an emotion-evoking task, with potential implications for understanding mechanisms related to emerging ASD.
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Affiliation(s)
- Lori-Ann R Sacrey
- Department of Pediatrics, University of Alberta/Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta/Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Jessica A Brian
- Bloorview Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Vickie Armstrong
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Tracy Vaillancourt
- Department of Education and Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Louis A Schmidt
- Department of Psychology, McMaster University, Hamilton, Ontario, Canada
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6
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Drmic I, Brian J, Roncadin C, Shaver C, Pase M, Rugajs N, Tofano K, Dowds E, Zwaigenbaum L, Smith IM, Bryson SE. Community implementation of a brief parent mediated intervention for toddlers with probable or confirmed autism spectrum disorder: feasibility, acceptability, and drivers of success (IE Drmic et al.). Front Pediatr 2024; 11:1295294. [PMID: 38322245 PMCID: PMC10844426 DOI: 10.3389/fped.2023.1295294] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/27/2023] [Indexed: 02/08/2024] Open
Abstract
Background Social ABCs is a caregiver-mediated Naturalistic Developmental Behavioral Intervention for toddlers with confirmed/suspected Autism Spectrum Disorder (ASD), with evidence in controlled research settings. Information is lacking on implementation in community settings. We reported on the treatment effectiveness of this program within a community setting, and the current paper describes the implementation phase of this work. Distinguishing between treatment and implementation effectiveness is critical for transporting interventions from laboratory to community. Objectives Describe the implementation of Social ABCs through a large public autism service, supported by a research-community partnership. Methods We describe this project through the Exploration, Preparation, Implementation, Sustainment (EPIS) framework as it focuses on implementation of evidence-based practices in publicly funded services. We apply this framework to the reporting stage. This project took place in the context of a 3-year government-funded pilot at a hospital-based publicly funded autism service. Participants: Program developers; Autism Service team; toddlers with suspected/confirmed ASD aged 14-34 months (M = 25.18 months) and their caregivers. Training/supervision: Provided by program developers at tapering intensity. Evaluation: Caregivers completed the Caregiver Diary and satisfaction surveys. We explored training processes, intervention uptake, acceptability, adaptations to fit community context, appropriateness, perceived impact, and facilitators/barriers. Results Six coaches were trained to fidelity, and three of these were further trained as Site Trainers. 183 clinically referred families enrolled and 89.4% completed the 12-week program. Caregivers reported increases in adherence and competence, high satisfaction and perceived benefits for their children. Coaches reported high satisfaction. Toddlers were appropriately identified to receive the intervention. Referral processes improved, including decreased referral age, and increased family readiness for diagnostic assessment and subsequent services. Conclusions Social ABCs was successfully implemented in a community service through a research-community partnership. The program was feasible, acceptable, and appropriate within a community context. Drivers of success included funding, institutional support, shared decision-making, adaptations to fit context, leadership support, perceived positive impact, and commitment to evaluation.
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Affiliation(s)
- Irene Drmic
- McMaster Children’s Hospital, Autism Program, Hamilton, ON, Canada
| | - Jessica Brian
- Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Chantelle Shaver
- McMaster Children’s Hospital, Autism Program, Hamilton, ON, Canada
| | - Marlene Pase
- McMaster Children’s Hospital, Autism Program, Hamilton, ON, Canada
| | - Natalie Rugajs
- McMaster Children’s Hospital, Autism Program, Hamilton, ON, Canada
| | - Kristina Tofano
- McMaster Children’s Hospital, Autism Program, Hamilton, ON, Canada
| | - Erin Dowds
- McMaster Children’s Hospital, Autism Program, Hamilton, ON, Canada
| | | | - Isabel M. Smith
- Department of Pediatrics and Department of Psychology & Neuroscience, Autism Research Centre, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Susan E. Bryson
- Department of Pediatrics and Department of Psychology & Neuroscience, Autism Research Centre, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
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Mirenda P, Zaidman-Zait A, Cost KT, Smith IM, Zwaigenbaum L, Duku E, Kerns C, Georgiades S, Vaillancourt T, Elsabbagh M, Bennett T, Szatmari P. Educators Describe the "Best Things" About Students with Autism at School. J Autism Dev Disord 2024; 54:1-17. [PMID: 36315320 DOI: 10.1007/s10803-022-05761-2] [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] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
This study examined educators' descriptions of the positive character traits of students with autism spectrum disorder at ages 7-8 and 10-11, using an adapted version of the Values in Action (VIA) Classification of Strengths. The most commonly endorsed strengths at both age intervals were kindness, specific skills, self-regulation, and perseverance. Higher scores for challenging behavior were associated with a lower likelihood of endorsement for Happiness and Courage traits. Higher autism symptom severity scores were associated with a lower likelihood of endorsement for Courage traits. Few significant differences were found for endorsement of trait categories by students' educational placement or the type of curriculum they received. Results may have implications for student-teacher relationships, educational assessments, and school-based interventions that emphasize strengths and resilience.
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Affiliation(s)
- Pat Mirenda
- University of British Columbia, 2125 Main Mall, V6T 1Z4, Vancouver, BC, Canada.
| | | | | | | | | | - Eric Duku
- McMaster University, Hamilton, Canada
| | - Connor Kerns
- University of British Columbia, 2125 Main Mall, V6T 1Z4, Vancouver, BC, Canada
| | | | | | - Mayada Elsabbagh
- McGill University/Montreal Children's Hospital, Montreal, Canada
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
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8
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Beauchamp MLH, Rezzonico S, Bennett T, Duku E, Georgiades S, Kerns C, Mirenda P, Richard A, Smith IM, Szatmari P, Vaillancourt T, Waddell C, Zaidman-Zait A, Zwaigenbaum L, Elsabbagh M. The Influence of Bilingual Language Exposure on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum. J Autism Dev Disord 2023; 53:4577-4590. [PMID: 36222993 PMCID: PMC10628039 DOI: 10.1007/s10803-022-05678-w] [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] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
We examined the narrative abilities of bilingual and monolingual children on the autism spectrum (AS), whether bilinguals presented stronger social and pragmatic language abilities compared to monolinguals, and the link between narrative, social, and pragmatic language abilities.The narrative, social, and pragmatic language skills of school-aged bilinguals (n = 54) and monolinguals (n = 80) on the AS were assessed using normed measures. Language exposure was estimated through a parent questionnaire.Bilinguals performed similarly to monolinguals on measures of narrative, social, and pragmatic language skills. However, balanced bilinguals performed better on a nonliteral language task.Overall, results indicate that bilingual children on the AS can become as proficient in using language as monolinguals and may enjoy a bilingual advantage.
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Affiliation(s)
| | | | | | - Eric Duku
- McMaster University, Hamilton, Canada
| | | | - Connor Kerns
- University of British Columbia, Vancouver, Canada
| | - Pat Mirenda
- University of British Columbia, Vancouver, Canada
| | - Annie Richard
- Dalhousie University and IWK Health, Halifax, NS, Canada
| | - Isabel M Smith
- Dalhousie University and IWK Health, Halifax, NS, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, The Hospital for Sick Children, Toronto, Canada
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9
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Wright N, Courchesne V, Pickles A, Bedford R, Duku E, Kerns CM, Bennett T, Georgiades S, Hill J, Richard A, Sharp H, Smith IM, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children. Psychol Med 2023; 53:7707-7719. [PMID: 37381780 PMCID: PMC10755241 DOI: 10.1017/s0033291723001599] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. METHODS Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. RESULTS Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. CONCLUSIONS Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.
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Affiliation(s)
- N. Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - V. Courchesne
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - A. Pickles
- Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - R. Bedford
- Department of Psychology, University of Bath, Bath, UK
| | - E. Duku
- McMaster University, Hamilton, Canada
| | - C. M. Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | | | | | - J. Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - A. Richard
- IWK Health Centre, Autism Research Centre, Halifax, Canada
| | - H. Sharp
- Department of Primary Care and Mental Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - I. M. Smith
- Dalhousie University and IWK Health, Halifax, Canada
| | | | | | | | - P. Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - M. Elsabbagh
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Pathways Team
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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10
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Lai MC, Amestoy A, Bishop S, Brown HM, Giwa Onaiwu M, Halladay A, Harrop C, Hotez E, Huerta M, Kelly A, Miller D, Nordahl CW, Ratto AB, Saulnier C, Siper PM, Sohl K, Zwaigenbaum L, Goldman S. Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities. Lancet Child Adolesc Health 2023; 7:897-908. [PMID: 37973254 DOI: 10.1016/s2352-4642(23)00221-3] [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] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 11/19/2023]
Abstract
Emerging evidence suggests that the higher prevalence of autism in individuals who are assigned male than assigned female at birth results from both biological factors and identification biases. Autistic individuals who are assigned female at birth (AFAB) and those who are gender diverse experience health disparities and clinical inequity, including late or missed diagnosis and inadequate support. In this Viewpoint, an international panel of clinicians, scientists, and community members with lived experiences of autism reviewed the challenges in identifying autism in individuals who are AFAB and proposed clinical and research directions to promote the health, development, and wellbeing of autistic AFAB individuals. The recognition challenges stem from the interplay between cognitive differences and nuanced or different presentations of autism in some AFAB individuals; expectancy, gender-related, and autism-related biases held by clinicians; and social determinants. We recommend that professional development for clinicians be supported by health-care systems, professional societies, and governing bodies to improve equitable access to assessment and earlier identification of autism in AFAB individuals. Autistic AFAB individuals should receive tailored support in education, identity development, health care, and social and professional sense of belonging.
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Affiliation(s)
- Meng-Chuan Lai
- Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health and The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, ON, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Anouck Amestoy
- Centre for Autism Spectrum Disorders, Aquitaine Institute for Cognitive and Integrative Neurosciences, Charles Perrens Hospital, University of Bordeaux, Bordeaux, France
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Heather M Brown
- Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Morénike Giwa Onaiwu
- Autistic Women & Nonbinary Network, Lincoln, NE, USA; Rice University Center for the Study of Women, Gender, and Sexuality, School of Humanities, Houston, TX, USA
| | - Alycia Halladay
- Autism Science Foundation, Scarsdale, NY, USA; Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ, USA
| | - Clare Harrop
- Department of Health Sciences and TEACCH Autism Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily Hotez
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Marisela Huerta
- Felicity House, New York, NY, USA; Weill Cornell Medicine, New York, NY, USA
| | - Amy Kelly
- Devereux Advanced Behavioral Health, Villanova, PA, USA
| | - Dylan Miller
- Auxiliary Enterprises, University of Massachusetts, Amherst, MA, USA
| | - Christine Wu Nordahl
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California at Davis, Davis, CA, USA
| | - Allison B Ratto
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Celine Saulnier
- Neurodevelopmental Assessment and Consulting Services, Decatur, GA, USA
| | - Paige M Siper
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristin Sohl
- ECHO Autism Communities, Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | | | - Sylvie Goldman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
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11
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Dhaliwal KK, Avedzi HM, Richard C, Zwaigenbaum L, Haqq AM. Brief Report: Plasma Leptin and Mealtime Feeding Behaviors Among Children with Autism Spectrum Disorder: A Pilot Study. J Autism Dev Disord 2023; 53:4929-4936. [PMID: 35583626 DOI: 10.1007/s10803-022-05581-4] [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] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
We examined the relationship between weight status, appetite regulating hormones, and mealtime behaviors among children, (5-12 years old), diagnosed with Autism Spectrum Disorder (ASD) in a cross-sectional study. All (N = 21) completed anthropometry measurements and (n = 18) provided blood samples for hormone analysis. Mealtime behavior, dietary, physical activity, puberty stage, and social impairment data were collected. Under fasting conditions, overweight/obese (OWOB) participants, (n = 6), had higher leptin concentrations (p < 0.02) and more feeding challenges (p < 0.05) than normal weight (n = 15). Higher leptin levels and disruptions in mealtime behaviors may exist among OWOB children in this study. Future longitudinal studies that examine appetite regulating hormones and mealtime behaviors may inform our understanding of the role of these markers in the development of obesity in ASD.
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Affiliation(s)
- Khushmol K Dhaliwal
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Hayford M Avedzi
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Caroline Richard
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Andrea M Haqq
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, 8440-112 St NW, Edmonton, AB, T6G 2B7, Canada.
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Canada.
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12
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Baribeau DA, Vigod SN, Pullenayegum E, Kerns CM, Vaillancourt T, Duku E, Smith IM, Volden J, Zwaigenbaum L, Bennett T, Elsabbagh M, Zaidman-Zait A, Richard AE, Szatmari P. Developmental cascades between insistence on sameness behaviour and anxiety symptoms in autism spectrum disorder. Eur Child Adolesc Psychiatry 2023; 32:2109-2118. [PMID: 35871413 DOI: 10.1007/s00787-022-02049-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/06/2022] [Indexed: 12/28/2022]
Abstract
Autistic children experience high rates of anxiety. Insistence on sameness behaviour (IS) is a core feature of autism that appears correlated with anxiety severity. The objective of this study was to examine the longitudinal relations between anxiety and IS in autistic children using a developmental cascade model. A longitudinal cohort of 421 autistic children was followed between 4 and 11 years of age. Anxiety was quantified using items from the Anxiety Problems subscale of the Child Behavior Checklist; sameness behaviours were measured using the Repetitive Behavior Scale-Revised, Ritualistic/sameness subscale (both parent-report measures). Structural equation modelling was used to examine the longitudinal and directional associations between anxiety and IS at four time-points, through cross-lagged panel models (CLPM) with and without a random-intercepts component (RI-CLPM). Both the CLPM and the RI-CLPM had good fit. Significant directional associations were detected whereby elevated or increasing IS preceded elevated or increasing anxiety symptoms 1-2 years later, respectively. Stable baseline tendencies towards anxiety and IS as between-person traits (intercepts) were strongly associated (standardized estimate = 0.69, p < 0.001). The magnitude of the cross-sectional associations between anxiety and IS appeared to lessen with age. IS and anxiety symptoms in autism are closely related. They appear to be shared traits that mirror each other particularly in younger children. Increasing IS may be a sign of emerging future anxiety. Interventions that target IS to reduce or prevent anxiety amongst school-aged autistic children merit further study.
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Affiliation(s)
- Danielle A Baribeau
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- The Hospital for Sick Children, Toronto, ON, Canada.
- The Hospital for Sick Children, University of Toronto, 123 Edward Street, 12th floor, Room 1210, Toronto, ON, M5G 1E2, Canada.
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
| | - Simone N Vigod
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Women's College Hospital and Women's College Research Institute, Toronto, ON, Canada
| | - Eleanor Pullenayegum
- The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Teresa Bennett
- Offord Centre for Child Studies, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Anat Zaidman-Zait
- Department of School Counseling and Special Education at the Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
- The School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Annie E Richard
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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13
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Goez H, Nielsen CC, Bryan S, Clark B, Zwaigenbaum L, Yamamoto SS, Osornio-Vargas AR. Autistic Regression and Exposure to Industrial Chemicals: Preliminary Observations - ERRATUM. Can J Neurol Sci 2023:1. [PMID: 37855232 DOI: 10.1017/cjn.2023.293] [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] [Indexed: 10/20/2023]
Affiliation(s)
- Helly Goez
- Division of Developmental Medicine and Rehabilitation, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | | | - Sean Bryan
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Brenda Clark
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | | | - Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Alvaro R Osornio-Vargas
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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14
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Sacrey LAR, Zwaigenbaum L, Elshamy Y, Smith IM, Brian JA, Wass S. Comparative strengths and challenges on face-to-face and computer-based attention tasks in autistic and neurotypical toddlers. Autism Res 2023; 16:1501-1511. [PMID: 37448306 DOI: 10.1002/aur.2983] [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: 03/10/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
The objectives were to compare patterns of visual attention in toddlers diagnosed with autism spectrum disorder (ASD) as compared to their sex- and age-matched neurotypical (NT) peers. Participants included 23 toddlers with ASD and 19 NT toddlers (mean age: 25.52 versus 25.21 months, respectively) assessed using computerized tasks to measure sustained attention, disengaging attention, and cognitive control, as well as an in-person task to assess joint attention. Toddlers in the ASD group showed increased looking durations on the sustained attention task, as well as reduced frequencies of responding to and initiating joint attention compared to NT peers, but showed no differences on tasks of disengaging attention and cognitive control. The results suggest that toddlers with ASD have attentional strengths that may provide a foundation for building attention, communicative, and ultimately, academic skills.
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Affiliation(s)
- Lori-Ann R Sacrey
- Autism Research Centre, Glenrose Rehabilitation Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Glenrose Rehabilitation Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Yomna Elshamy
- Autism Research Centre, Glenrose Rehabilitation Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Isabel M Smith
- IWK Health Centre and Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jessica A Brian
- Bloorview Research Institute and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sam Wass
- Department of Psychological Sciences, University of East London, London, UK
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15
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Susko M, Armstrong VL, Brian JA, Bryson SE, Kushki A, Sacrey LAR, Zwaigenbaum L, Smith IM. Behavioural reactions to an emotion evoking task in infants at increased likelihood for autism spectrum disorder. Infant Behav Dev 2023; 72:101848. [PMID: 37307722 DOI: 10.1016/j.infbeh.2023.101848] [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: 01/20/2022] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/14/2023]
Abstract
Infants at increased likelihood for autism spectrum disorder (ASD) exhibit more negative affect and avoidance behaviour than typically developing infants, and children with ASD express fear differently than typically developing peers. We examined behavioural reactions to emotion-evoking stimuli in infants at increased familial likelihood for ASD. Participants included 55 increased likelihood (IL) infants (i.e., siblings of children diagnosed with ASD) and 27 typical likelihood (TL) infants (i.e., no family history of ASD). At 18 months, we showed infants two masks that commonly elicit fearful responses in older children and examined potential behavioural differences in approach, avoidance, 'freezing', crying, gaze aversion, and smiling. At 24 months, infants were assessed with the Toddler Module of the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2). Results of video-based coding showed that (1) IL infants exhibited more intense avoidance behaviour than TL infants in response to masks, and (2) intensity of avoidance and duration of freezing were positively correlated with ADOS-2 symptom severity scores. Findings suggest that differences in response to emotion-eliciting stimuli may predict later ASD symptoms. Such behavioural differences may inform early detection and intervention in ASD.
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Affiliation(s)
- Melissa Susko
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
| | | | - Jessica A Brian
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, ON, Canada; Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Susan E Bryson
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Azadeh Kushki
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | | | | | - Isabel M Smith
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
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16
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Bruno G, Chan TA, Zwaigenbaum L, Coombs E, Nicholas D. Indigenous Autism in Canada: A Scoping Review. J Autism Dev Disord 2023:10.1007/s10803-023-06045-z. [PMID: 37480443 DOI: 10.1007/s10803-023-06045-z] [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] [Accepted: 06/08/2023] [Indexed: 07/24/2023]
Abstract
Currently there is a severe lack of research on autism and Indigenous people in Canada. This scoping review explores this literature gap and assesses the same literature from an Indigenous perspective. Scoping reviews are an effective means to explore the literature in a specific area, in this case, autism and Indigenous people in Canada. We explored existing literature as it pertains to Indigenous populations and autism in Canada. To support this review, the Indigenous Quality Assessment Tool (QAT) was adapted to appraise the quality of literature. In total, there were a total of 212 articles identified of which 24 met the inclusion criteria: (1) some focus on autism, (2) a component specific to Indigenous people, and (3) specific to Canada. Of the 24 articles and reports, 15 were peer-reviewed and the rest considered grey literature. Most articles focused on program delivery with some literature using primary data (quantitative and/or qualitative). Overall, the quality of the research was appraised as poor, as determined by the QAT. Findings reaffirm the critical need for research that addresses autism in Indigenous communities within Canada and show the importance of having research done in full partnership with, or led by, Indigenous people.
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Affiliation(s)
- Grant Bruno
- Department of Pediatrics, Edmonton Clinic Health Academy, University of Alberta, 11405- 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
- Samson Cree Nation, Maskwacîs, AB, Canada.
| | | | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta c/o Glenrose Rehabilitation Hospital, 10230 111th Avenue, Edmonton, AB, T5G 0B, Canada
| | - Emily Coombs
- Department of Educational Psychology, Counselling Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - David Nicholas
- Faculty of Social Work, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
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17
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Thompson-Hodgetts S, McKillop A, Couture M, Shire S, Weiss JA, Zwaigenbaum L. Influence of a Brief Autism Education Intervention on Peer Engagement and Inclusion At Mainstream Day Camps: A Mixed-Methods Pilot Study. J Autism Dev Disord 2023:10.1007/s10803-023-06024-4. [PMID: 37314666 DOI: 10.1007/s10803-023-06024-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/15/2023]
Abstract
To explore the benefits of a brief autism education intervention on peer engagement and inclusion of autistic children at day camps. A convergent, parallel, two-arm (intervention/no intervention), non-randomized, mixed-methods design was used. The individualized, peer-directed, 5-10 min intervention included four components: (1) diagnostic label, (2) description and purpose of unique behaviors, (3) favorite activities and interests, and (4) strategies to engage. A timed-interval behavior-coding system was used to evaluate engagement between each autistic camper and their peers based on videos taken at camp (days 1, 2, 5). Interviews with campers and camp staff explored why changes in targeted outcomes may have occurred. Percent intervals in which the autistic campers were jointly engaged with peers improved in the intervention group (n = 10) and did not change in the control group (n = 5). A large between group intervention effect occurred by day 5 (Z = - 1.942, η2 = 0.29). Interviews (5 autistic campers, 34 peers, 18 staff) done on the last day of camp in the intervention group garnered three themes: (1) Changed behavioral attribution, (2) Knowledge facilitates understanding and engagement, and (3) (Mis)perceptions of increased inclusion. A brief educational intervention that includes individualized explanatory information and strengths-based strategies might improve peers' understanding of and social engagement with autistic children in community programs such as camps.
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Affiliation(s)
- Sandy Thompson-Hodgetts
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-64 Corbett Hall University of Alberta, Edmonton, AB, T6G 2G4, Canada.
| | - Ashley McKillop
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Mélanie Couture
- École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Stephanie Shire
- Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, USA
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18
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Estrada KA, Govindaraj S, Abdi H, Moraglia LE, Wolff JJ, Meera SS, Dager SR, McKinstry RC, Styner MA, Zwaigenbaum L, Piven J, Swanson MR. Language exposure during infancy is negatively associated with white matter microstructure in the arcuate fasciculus. Dev Cogn Neurosci 2023; 61:101240. [PMID: 37060675 PMCID: PMC10130606 DOI: 10.1016/j.dcn.2023.101240] [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: 10/30/2022] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/17/2023] Open
Abstract
Decades of research have established that the home language environment, especially quality of caregiver speech, supports language acquisition during infancy. However, the neural mechanisms behind this phenomenon remain under studied. In the current study, we examined associations between the home language environment and structural coherence of white matter tracts in 52 typically developing infants from English speaking homes in a western society. Infants participated in at least one MRI brain scan when they were 3, 6, 12, and/or 24 months old. Home language recordings were collected when infants were 9 and/or 15 months old. General linear regression models indicated that infants who heard the most adult words and participated in the most conversational turns at 9 months of age also had the lowest fractional anisotropy in the left posterior parieto-temporal arcuate fasciculus at 24 months. Similarly, infants who vocalized the most at 9 months also had the lowest fractional anisotropy in the same tract at 6 months of age. This is one of the first studies to report significant associations between caregiver speech collected in the home and white matter structural coherence in the infant brain. The results are in line with prior work showing that protracted white matter development during infancy confers a cognitive advantage.
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Affiliation(s)
- Katiana A Estrada
- Department of Psychological Sciences, Purdue University, West Lafayette, IN 47906, USA; Department of Psychology, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Sharnya Govindaraj
- Department of Psychology, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Hervé Abdi
- Department of Psychology, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Luke E Moraglia
- Department of Psychology, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Shoba Sreenath Meera
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bangalore, India
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA 98195, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63130, USA
| | - Martin A Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton AB T6G 2R3, Canada
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Meghan R Swanson
- Department of Psychology, The University of Texas at Dallas, Richardson, TX 75080, USA.
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19
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Gehring ND, Birken CS, Belanger S, Bridger T, Chanoine JP, Gibson WT, Hadjiyannakis S, Haines J, Hamilton J, Haqq AM, Henderson M, Ho J, Irvine B, Legault L, Luca P, Maguire J, McPherson AC, Morrison K, Wahi G, Weksberg R, Zwaigenbaum L, Ball GDC. Severe obesity and global developmental delay in preschool children: Findings from a Canadian Paediatric Surveillance Program study. Paediatr Child Health 2023; 28:107-112. [PMID: 37151929 PMCID: PMC10156927 DOI: 10.1093/pch/pxac109] [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] [Received: 05/13/2022] [Accepted: 10/12/2022] [Indexed: 11/15/2022] Open
Abstract
Background The co-presentation of severe obesity (SO) and global developmental delay (GDD) in Canadian preschool children has not been examined. However, SO and GDD may require syndromic diagnoses and unique management considerations. Objectives To determine (1) minimum incidence; (2) age of onset and risk factors; and (3) health care utilization for co-presenting SO and GDD. Methods Through the Canadian Paediatric Surveillance Program (CPSP), a monthly form was distributed to participants from February 2018 to January 2020 asking for reports of new cases of SO and GDD among children ≤5 years of age. We performed descriptive statistics for quantitative questions and qualitative content analysis for open-ended questions. Results Forty-seven cases (64% male; 51% white; mean age: 3.5 ± 1.2 years) were included. Age of first weight concern was 2.5 ± 1.3 years and age of GDD diagnosis was 2.7 ± 1.4 years. Minimum incidence of SO and GDD was 3.3 cases per 100,000 for ≤5 years of age per year. Identified problems included school and/or behavioural problems (n = 17; 36%), snoring (n = 14; 30%), and asthma/recurrent wheeze (n = 10; 21%). Mothers of 32% of cases (n = 15) had obesity and 21% of cases (n = 10) received neonatal intensive care. Microarray was ordered for 57% (n = 27) of children. A variety of clinicians and services were accessed. As reported by CPSP participants, challenges faced by families and health service access were barriers to care. Conclusion Children with SO and GDD have multiple comorbidities, and require early identification and referral to appropriate services. These cases may also benefit from additional testing to rule out known genetic obesity syndromes.
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Affiliation(s)
- Nicole D Gehring
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine S Birken
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Stacey Belanger
- Department of Pediatrics, University of Montreal, Montreal, Québec, Canada
| | - Tracey Bridger
- Discipline of Pediatrics, Memorial University, St. John’s, Newfoundland and Labrador, Canada
| | - Jean-Pierre Chanoine
- Division of Endocrinology, University of British Columbia, Vancouver, British Columbia, Canada
| | - William T Gibson
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Jess Haines
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Jill Hamilton
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Andrea M Haqq
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Mélanie Henderson
- Department of Pediatrics, University of Montreal, Montreal, Québec, Canada
| | - Josephine Ho
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | | | - Laurent Legault
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Paola Luca
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Jonathon Maguire
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Amy C McPherson
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Katherine Morrison
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Gita Wahi
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Rosanna Weksberg
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Geoff D C Ball
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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20
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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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21
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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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22
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Chen YJ, Duku E, Zaidman-Zait A, Szatmari P, Smith IM, Ungar WJ, Zwaigenbaum L, Vaillancourt T, Kerns C, Bennett T, Elsabbagh M, Thompson A, Georgiades S. Variable patterns of daily activity participation across settings in autistic youth: A latent profile transition analysis. Autism 2023; 27:13623613231154729. [PMID: 36855223 PMCID: PMC10576904 DOI: 10.1177/13623613231154729] [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] [Indexed: 03/02/2023]
Abstract
LAY ABSTRACT What people do or engage in in their daily lives, or daily life participation, is often linked to their state of being happy and healthy, as well as potential for living independently. To date, little research has been conducted on daily activity participation by autistic youth at home, at school or in the community. Learning more about individual differences in participation levels and what might influence them can help to create custom supports for autistic youth and their families. In this study, 158 caregivers of autistic youth were asked how often their children took part in 25 common activities at two assessments, about one year apart. The analysis showed three profiles for each of the home and school settings and two profiles for the community setting. These profiles reflected distinct patterns in how often autistic youth took part in various daily activities, particularly in doing homework, school club activities and community gatherings. Most autistic youth were in profiles marked by often taking part at home but less often at school and in the community, and about three-fourths of them tended to stay in the same profile over time. Autistic youth with limited participation profiles were more likely to have lower scores on measures of cognitive ability and daily life skills and more challenging behaviour, and faced more barriers in their environment. These findings show how important it is to think about each autistic person's strengths and weaknesses, and changing needs, to better support their daily life participation.
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Affiliation(s)
| | | | | | - Peter Szatmari
- The Hospital for Sick Children, Canada
- University of Toronto, Canada
- Centre for Addiction and Mental Health, Canada
| | | | - Wendy J Ungar
- The Hospital for Sick Children, Canada
- University of Toronto, Canada
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23
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McVey AJ, Liu Q, Bedford SA, Zaidman-Zait A, Szatmari P, Smith IM, Vaillancourt T, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Kerns CM. Examining clinical characteristics of autism and links with parent perceptions of sibling relationship quality. Autism 2023; 27:309-320. [PMID: 35510331 DOI: 10.1177/13623613221094672] [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] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Sibling relationship quality is important for the well-being of children on the autism spectrum and their siblings. Little is known, however, about how varied behavior and abilities of children on the autism spectrum may be associated with parent perceptions of domains of sibling relationship quality. We drew data from a subsample of 119 children on the autism spectrum (ages 10-11 years), participating in an ongoing longitudinal study. We looked at how three clinical characteristics (autism symptoms, behavioral difficulties, and communication ability) related to four areas of parent-reported sibling relationship quality (warmth/closeness, conflict, relative status/power, and rivalry). We also examined whether the strength of the association between behavioral difficulties and parent-reported sibling relationship quality was influenced by communication ability. We found that more severe autism symptoms were associated with less conflict and rivalry, and higher communication ability was associated with more relative status/power. We also found that children on the autism spectrum with more behavioral difficulties and weaker communication ability had less warmth/closeness in their sibling relationships. Our findings highlight that it is important to consider autism symptoms, behavioral difficulties, and communication ability, as well as multiple domains of relationship quality, to better understand how parents view the relationships between autistic children and their siblings. Clinically, methods for improving sibling relationships may include teaching conflict resolution strategies to children on the autism spectrum with stronger communication abilities and their siblings, and fostering sibling connection for those with lower communication abilities.
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Affiliation(s)
- Alana J McVey
- University of British Columbia, Canada.,University of Washington, USA
| | - Quinn Liu
- University of British Columbia, Canada
| | - Saashi A Bedford
- University of British Columbia, Canada.,University of Cambridge, UK
| | | | | | | | | | | | - Teresa Bennett
- McMaster University, Canada.,Offord Centre for Child Studies, Canada
| | - Eric Duku
- McMaster University, Canada.,Offord Centre for Child Studies, Canada
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24
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Leno VC, Wright N, Pickles A, Bedford R, Zaidman-Zait A, Kerns C, Zwaigenbaum L, Duku E, Bennett T, Georgiades S, Smith IM, Richards A, Vaillancourt T, Szatmari P, Elsabbagh M. Longitudinal associations between early childhood irritability and adolescent depression symptoms in autistic children are mediated by peer relationships but not educational engagement. Dev Psychopathol 2023; 36:1-11. [PMID: 36700357 PMCID: PMC7615659 DOI: 10.1017/s0954579422001316] [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] [Indexed: 01/27/2023]
Abstract
In the general population, irritability is associated with later depression. Despite irritability being more prevalent in autistic children, the long-term sequelae are not well explored. We tested whether irritability in early childhood predicted depression symptoms in autistic adolescents, and whether associations could be explained by difficulties in peer relationships and lower educational engagement. Analyses tested the longitudinal associations between early childhood irritability (ages 3-5) and adolescent depression symptoms (age 14) in a prospective inception cohort of autistic children (N = 390), followed from early in development shortly after they received a clinical diagnosis. Mediators were measured in mid-childhood (age 10) by a combination of measures, from which latent factors for peer relationships and educational engagement were estimated. Results showed early childhood irritability was positively associated with adolescent depression symptoms, and this association remained when adjusting for baseline depression. A significant indirect pathway through peer relationships was found, which accounted for around 13% of the association between early childhood irritability and adolescent depression, suggesting peer problems may partially mediate the association between irritability and later depression. No mediation effects were found for education engagement. Results highlight the importance of early screening and intervention for co-occurring irritability and peer problems in young autistic children.
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Affiliation(s)
- Virginia Carter Leno
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
| | - Nicola Wright
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Department of Psychology, Manchester Metropolitan University, United Kingdom
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
| | - Rachael Bedford
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Department of Psychology, University of Bath, United Kingdom
| | | | - Connor Kerns
- University of British Columbia, Vancouver, Canada
| | | | - Eric Duku
- McMaster University, Hamilton, Ontario, Canada
| | | | | | - Isabel M. Smith
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Annie Richards
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ontario, Canada
| | - Peter Szatmari
- University of Toronto, Canada
- Centre for Addiction and Mental Health, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Quebec, Canada
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25
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Tsiplova K, Ungar WJ, Szatmari P, Cost K, Pullenayegum E, Duku E, Volden J, Smith IM, Waddell C, Zwaigenbaum L, Bennett TA, Elsabbagh M, Georgiades S, Zaidman-Zait A. Measuring the association between behavioural services and outcomes in young children with autism spectrum disorder. Res Dev Disabil 2023; 132:104392. [PMID: 36493738 DOI: 10.1016/j.ridd.2022.104392] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) receive a wide range of services. AIMS To examine the association between behavioural services received by children with ASD between ages 2 and 5 years and outcomes during primary school years. METHODS A total of 414 preschool-aged children diagnosed with ASD were enrolled at five Canadian sites and were assessed within four months of diagnosis (T1), six months later (T2), 12 months later (T3), at school entry (T4), and then annually (T5-T8) to 11 years of age. The association between the receipt of behavioural services during T1 to T3 and T8 outcomes related to adaptive behaviour and behavioural problems was modelled using linear regressions adjusted for immigrant status, family income, child's age at diagnosis, site, sex assigned at birth, and baseline (T1) outcome. RESULTS Children who received behavioural services during at least one time period from T1 to T3 did not have significantly different outcomes at T8 than children who did not receive any behavioural services. IMPLICATIONS Pre-school use of behavioural services was not found to affect outcomes during later childhood. Numerous challenges accompany studies of the association between pre-school service use and later outcomes in a heterogeneous ASD sample. Recommendations for study design are provided.
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Affiliation(s)
- Kate Tsiplova
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada.
| | - Peter Szatmari
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Katherine Cost
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, 8205 114 Street, 3-48 Corbett Hall, Edmonton, Alberta T6G 2G4, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850 University Avenue, P. O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada; Autism Research Centre, IWK Health Centre, 4th Floor Link Building, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Room 2435, 515 West Hastings Street Vancouver, British Columbia V6B 5K, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue Edmonton, Alberta T6G 1C9, Canada
| | - Teresa A Bennett
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Anat Zaidman-Zait
- Department of School Counseling and Special Education, Constantiner School of Education, Tel Aviv University, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel; The School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
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26
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Hawks ZW, Todorov A, Marrus N, Nishino T, Talovic M, Nebel MB, Girault JB, Davis S, Marek S, Seitzman BA, Eggebrecht AT, Elison J, Dager S, Mosconi MW, Tychsen L, Snyder AZ, Botteron K, Estes A, Evans A, Gerig G, Hazlett HC, McKinstry RC, Pandey J, Schultz RT, Styner M, Wolff JJ, Zwaigenbaum L, Markson L, Petersen SE, Constantino JN, White DA, Piven J, Pruett JR. A Prospective Evaluation of Infant Cerebellar-Cerebral Functional Connectivity in Relation to Behavioral Development in Autism Spectrum Disorder. Biol Psychiatry Glob Open Sci 2023; 3:149-161. [PMID: 36712571 PMCID: PMC9874081 DOI: 10.1016/j.bpsgos.2021.12.004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 02/01/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder diagnosed based on social impairment, restricted interests, and repetitive behaviors. Contemporary theories posit that cerebellar pathology contributes causally to ASD by disrupting error-based learning (EBL) during infancy. The present study represents the first test of this theory in a prospective infant sample, with potential implications for ASD detection. Methods Data from the Infant Brain Imaging Study (n = 94, 68 male) were used to examine 6-month cerebellar functional connectivity magnetic resonance imaging in relation to later (12/24-month) ASD-associated behaviors and outcomes. Hypothesis-driven univariate analyses and machine learning-based predictive tests examined cerebellar-frontoparietal network (FPN; subserves error signaling in support of EBL) and cerebellar-default mode network (DMN; broadly implicated in ASD) connections. Cerebellar-FPN functional connectivity was used as a proxy for EBL, and cerebellar-DMN functional connectivity provided a comparative foil. Data-driven functional connectivity magnetic resonance imaging enrichment examined brain-wide behavioral associations, with post hoc tests of cerebellar connections. Results Cerebellar-FPN and cerebellar-DMN connections did not demonstrate associations with ASD. Functional connectivity magnetic resonance imaging enrichment identified 6-month correlates of later ASD-associated behaviors in networks of a priori interest (FPN, DMN), as well as in cingulo-opercular (also implicated in error signaling) and medial visual networks. Post hoc tests did not suggest a role for cerebellar connections. Conclusions We failed to identify cerebellar functional connectivity-based contributions to ASD. However, we observed prospective correlates of ASD-associated behaviors in networks that support EBL. Future studies may replicate and extend network-level positive results, and tests of the cerebellum may investigate brain-behavior associations at different developmental stages and/or using different neuroimaging modalities.
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Affiliation(s)
- Zoë W. Hawks
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
- Address correspondence to Zoë W. Hawks, Ph.D.
| | - Alexandre Todorov
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Muhamed Talovic
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Mary Beth Nebel
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jessica B. Girault
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Savannah Davis
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Scott Marek
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Benjamin A. Seitzman
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Adam T. Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Jed Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | - Stephen Dager
- Departments of Radiology, University of Washington, Seattle, Washington
| | - Matthew W. Mosconi
- Life Span Institute and Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas
| | - Lawrence Tychsen
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Abraham Z. Snyder
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kelly Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Annette Estes
- Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Alan Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Guido Gerig
- Department of Computer Science and Engineering, Tandon School of Engineering, New York University, New York, New York
| | - Heather C. Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, 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, Philadelphia, Pennsylvania
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Lonnie Zwaigenbaum
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Lori Markson
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Steven E. Petersen
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - John N. Constantino
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Desirée A. White
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Joseph Piven
- Department of Psychiatry, 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
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Franchini M, Smith IM, Sacrey L, Duku E, Brian J, Bryson SE, Vaillancourt T, Armstrong V, Szatmari P, Roberts W, Roncadin C, Zwaigenbaum L. Continuity of trajectories of autism symptom severity from infancy to childhood. J Child Psychol Psychiatry 2022; 64:895-906. [PMID: 36562606 DOI: 10.1111/jcpp.13744] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Behavioral symptom trajectories are informative of the development of young children at increased likelihood for autism spectrum disorder (ASD). METHODS Developmental trajectories of early signs were examined in a cohort of siblings of children diagnosed with ASD (n = 502) from 6 to 18 months using the Autism Observation Scale for Infants (AOSI), and from 18 months to 5-7 years using the Autism Diagnostic Observation Schedule (ADOS). Diagnostic outcomes for ASD at age 3 confirmed diagnosis for 137 children. We further analyzed the conditional probability of a switch from a trajectory measured with the AOSI to a trajectory measured with the ADOS as well as predictors from age 6 months. RESULTS We derived three early trajectories of behavioral signs ("Low," "Intermediate," and "Increasing") from 6 to 18 months using the AOSI. We then derived three similar, distinct trajectories for the evolution of symptom severity between 18 and 60-84 months of age (Low, Intermediate, Increasing) using the ADOS. Globally, the Low trajectory included children showing fewer ASD signs or symptoms and the Increasing trajectory included children showing more severe symptoms. We also found that most children in the Low AOSI trajectory stayed in the corresponding ADOS trajectory, whereas children in an Increasing AOSI trajectory tended to transition to an Intermediate or Increasing ADOS trajectory. Developmental measures taken at 6 months (early signs of ASD, Fine Motor, and Visual Reception skills) were predictive of trajectory membership. CONCLUSIONS Results confirm substantial heterogeneity in the early emergence of ASD signs in children at increased likelihood for ASD. Moreover, we showed that the way those early behavioral signs emerge in infants is predictive of later symptomatology. Results yield clear clinical implications, supporting the need to repeatedly assess infants at increased likelihood for ASD as this can be highly indicative of their later development and behavior.
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Affiliation(s)
- Martina Franchini
- Fondation Pôle Autisme and Faculty of Educational Psychology and Sciences, University of Geneva, Geneva, Switzerland
| | - Isabel M Smith
- Autism Research Centre, IWK Health Centre, Halifax, Canada.,Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Lori Sacrey
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jessica Brian
- Bloorview Research Institute and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bryson
- Autism Research Centre, IWK Health Centre, Halifax, Canada.,Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Wendy Roberts
- Integrated Services for Autism and Neurodevelopmental Disorders, Toronto, ON, Canada
| | - Caroline Roncadin
- McMaster Children's Hospital Autism Program, Hamilton Health Sciences, Hamilton, Canada
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28
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Farmer C, Thurm A, Condy E, Duku E, Szatmari P, Bennett T, Elsabbagh M, Kerns CM, Smith IM, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Georgiades S. Disentangling global and domain-level adaptive behavior trajectories among children with autism spectrum disorder. J Child Psychol Psychiatry 2022; 64:868-875. [PMID: 36562498 PMCID: PMC10369325 DOI: 10.1111/jcpp.13741] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Heterogeneity in adaptive behavior abilities among people with autism spectrum disorder (ASD) is expressed not only as uneven levels of impairment across domains, but also in the developmental trajectories of adaptive skills. We studied the question of whether, after accounting for global adaptive behavior development, we find evidence of heterogeneity in the trajectories of specific domains of adaptive behavior. METHODS A sample of 504 children with ASD was obtained by combining data from two independent natural history studies conducted in North America. We used a factor of curves model to explain growth between 36 and 138 months in Vineland Adaptive Behavior Scales, Second Edition (VABS) age equivalents as a function of domain-specific and global growth processes. RESULTS The domain-specific trajectories in all three domains (Communication, Daily Living Skills, and Socialization) reflected impairment relative to age expectations as well as slower-than-expected growth with age, and the parameters of these trajectories were moderately-to-strongly correlated across domains. The global adaptive behavior trajectory had an initial (36-41 months of age) developmental level of about 22 age-equivalent months, and eventually slowed after initially increasing by about 6 months each year. The global trajectory accounted for the majority of variance in the domain-level processes; however, additional variance remained (14%-38%) in the domain-level intercepts, slopes, and quadratic processes. CONCLUSIONS These results extend existing theoretical and empirical support for the hierarchical structure of adaptive behavior to include its development over time in clinical samples of children with ASD. A latent global trajectory may be sufficient to describe the growth of adaptive behavior in children with ASD; however, the remaining domain-specific variability after accounting for global adaptive behavior development allows for the possibility that differential effects of intervention on specific domains may be possible and detectable.
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Affiliation(s)
- Cristan Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Emma Condy
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
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29
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Trost B, Thiruvahindrapuram B, Chan AJS, Engchuan W, Higginbotham EJ, Howe JL, Loureiro LO, Reuter MS, Roshandel D, Whitney J, Zarrei M, Bookman M, Somerville C, Shaath R, Abdi M, Aliyev E, Patel RV, Nalpathamkalam T, Pellecchia G, Hamdan O, Kaur G, Wang Z, MacDonald JR, Wei J, Sung WWL, Lamoureux S, Hoang N, Selvanayagam T, Deflaux N, Geng M, Ghaffari S, Bates J, Young EJ, Ding Q, Shum C, D'Abate L, Bradley CA, Rutherford A, Aguda V, Apresto B, Chen N, Desai S, Du X, Fong MLY, Pullenayegum S, Samler K, Wang T, Ho K, Paton T, Pereira SL, Herbrick JA, Wintle RF, Fuerth J, Noppornpitak J, Ward H, Magee P, Al Baz A, Kajendirarajah U, Kapadia S, Vlasblom J, Valluri M, Green J, Seifer V, Quirbach M, Rennie O, Kelley E, Masjedi N, Lord C, Szego MJ, Zawati MH, Lang M, Strug LJ, Marshall CR, Costain G, Calli K, Iaboni A, Yusuf A, Ambrozewicz P, Gallagher L, Amaral DG, Brian J, Elsabbagh M, Georgiades S, Messinger DS, Ozonoff S, Sebat J, Sjaarda C, Smith IM, Szatmari P, Zwaigenbaum L, Kushki A, Frazier TW, Vorstman JAS, Fakhro KA, Fernandez BA, Lewis MES, Weksberg R, Fiume M, Yuen RKC, Anagnostou E, Sondheimer N, Glazer D, Hartley DM, Scherer SW. Genomic architecture of autism from comprehensive whole-genome sequence annotation. Cell 2022; 185:4409-4427.e18. [PMID: 36368308 PMCID: PMC10726699 DOI: 10.1016/j.cell.2022.10.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [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: 05/05/2022] [Revised: 08/30/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
Abstract
Fully understanding autism spectrum disorder (ASD) genetics requires whole-genome sequencing (WGS). We present the latest release of the Autism Speaks MSSNG resource, which includes WGS data from 5,100 individuals with ASD and 6,212 non-ASD parents and siblings (total n = 11,312). Examining a wide variety of genetic variants in MSSNG and the Simons Simplex Collection (SSC; n = 9,205), we identified ASD-associated rare variants in 718/5,100 individuals with ASD from MSSNG (14.1%) and 350/2,419 from SSC (14.5%). Considering genomic architecture, 52% were nuclear sequence-level variants, 46% were nuclear structural variants (including copy-number variants, inversions, large insertions, uniparental isodisomies, and tandem repeat expansions), and 2% were mitochondrial variants. Our study provides a guidebook for exploring genotype-phenotype correlations in families who carry ASD-associated rare variants and serves as an entry point to the expanded studies required to dissect the etiology in the ∼85% of the ASD population that remain idiopathic.
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Affiliation(s)
- Brett Trost
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | | | - Ada J S Chan
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Worrawat Engchuan
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Edward J Higginbotham
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jennifer L Howe
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Livia O Loureiro
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Miriam S Reuter
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; CGEn, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Delnaz Roshandel
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Joe Whitney
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Mehdi Zarrei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | | | - Cherith Somerville
- Ted Rogers Centre for Heart Research, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Rulan Shaath
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Mona Abdi
- Department of Human Genetics, Sidra Medicine, Doha, Qatar; College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Elbay Aliyev
- Department of Human Genetics, Sidra Medicine, Doha, Qatar
| | - Rohan V Patel
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Thomas Nalpathamkalam
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Giovanna Pellecchia
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Omar Hamdan
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Gaganjot Kaur
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Zhuozhi Wang
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jeffrey R MacDonald
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - John Wei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Wilson W L Sung
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sylvia Lamoureux
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Ny Hoang
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Thanuja Selvanayagam
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Nicole Deflaux
- Verily Life Sciences, South San Francisco, CA 94080, USA
| | - Melissa Geng
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Siavash Ghaffari
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - John Bates
- Verily Life Sciences, South San Francisco, CA 94080, USA
| | - Edwin J Young
- Genome Diagnostics, Department of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Qiliang Ding
- Ted Rogers Centre for Heart Research, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Carole Shum
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Lia D'Abate
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Clarrisa A Bradley
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Annabel Rutherford
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Vernie Aguda
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Beverly Apresto
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Nan Chen
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sachin Desai
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Xiaoyan Du
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Matthew L Y Fong
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sanjeev Pullenayegum
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Kozue Samler
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Ting Wang
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Karen Ho
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Tara Paton
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sergio L Pereira
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jo-Anne Herbrick
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Richard F Wintle
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | - Olivia Rennie
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada; Department of Psychiatry, Queen's University, Kingston, ON K7L 7X3, Canada
| | - Nina Masjedi
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90024, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90024, USA
| | - Michael J Szego
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Ma'n H Zawati
- Department of Human Genetics, McGill University, Montreal, QC H3A 0C7, Canada
| | - Michael Lang
- Department of Human Genetics, McGill University, Montreal, QC H3A 0C7, Canada
| | - Lisa J Strug
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Statistical Sciences, University of Toronto, Toronto, ON M5S 3G3, Canada
| | - Christian R Marshall
- Genome Diagnostics, Department of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Gregory Costain
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Kristina Calli
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada; BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Alana Iaboni
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Afiqah Yusuf
- Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Patricia Ambrozewicz
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Louise Gallagher
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Child, Youth and Family Services, The Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - David G Amaral
- MIND Institute, University of California, Davis, Sacramento, CA 95817, USA; Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA 95817, USA
| | - Jessica Brian
- Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada
| | | | - Sally Ozonoff
- MIND Institute, University of California, Davis, Sacramento, CA 95817, USA; Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA 95817, USA
| | - Jonathan Sebat
- Department of Psychiatry and Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Calvin Sjaarda
- Department of Psychiatry, Queen's University, Kingston, ON K7L 7X3, Canada; Queen's Genomics Lab at Ongwanada, Queen's University, Kingston, ON K7M 8A6, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada; IWK Health Centre, Halifax, NS B3K 6R8, Canada
| | - Peter Szatmari
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Azadeh Kushki
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Thomas W Frazier
- Autism Speaks, Princeton, NJ 08540, USA; Department of Psychology, John Carroll University, Cleveland, OH 44118, USA
| | - Jacob A S Vorstman
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Khalid A Fakhro
- Department of Human Genetics, Sidra Medicine, Doha, Qatar; College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar; Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar
| | - Bridget A Fernandez
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA; Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
| | - M E Suzanne Lewis
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada; BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Rosanna Weksberg
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | | | - Ryan K C Yuen
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Evdokia Anagnostou
- Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Neal Sondheimer
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - David Glazer
- Verily Life Sciences, South San Francisco, CA 94080, USA
| | | | - Stephen W Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; McLaughlin Centre, Toronto, ON M5G 0A4, Canada.
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30
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Tesfaye R, Courchesne V, Mirenda P, Mitchell W, Nicholas D, Singh I, Zwaigenbaum L, Elsabbagh M. Autism voices: Perspectives of the needs, challenges, and hopes for the future of autistic youth. Autism 2022; 27:1142-1156. [PMID: 36329663 DOI: 10.1177/13623613221132108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Autism Voices study draws on novel inclusive methods to obtain the first-person experiences of autistic youth with a range of cognitive and verbal abilities. Thirty-one autistic youth were interviewed with a strength-based protocol, enabling them to provide responses in the modality of their choice. Dynamics between youth and their environments such as home, school, and community were explored. Youth were questioned about their interests, plans for the future, experiences with various emotions, and experience of autism. Based on a thematic analysis, six themes emerged: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. The experiences described by autistic youth parallel many of the aspirations and challenges of typically developing adolescents, while being uniquely shaped by their autism. We discuss how these insights shared by autistic youth can facilitate active involvement in their communities, promote well-being, and promote optimal transition into adulthood. Autism Voices demonstrates that partnering with multiple stakeholders and the use of inclusive methodologies are pivotal steps toward capturing the voices of all autistic youth. Lay abstract Currently, our understanding of the adolescent period for autistic youth has relied on the expertise of researchers, clinicians, parents, and teachers, yet rarely involves their unique first-person experiences. Our study attempted to understand the experiences and perspectives of autistic adolescents in their home, school, and community environments using the Autism Voices protocol, a semi-structured interview specifically designed and tailored to engage with autistic youth with various language and intellectual levels. The analysis of the 31 interviews conducted with autistic adolescents aged 11–18 years highlighted six themes: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. These results highlight similarities and differences in the adolescent experiences of autistic youth compared to their typically developing peers. Our findings suggest that by removing assumptions about the experiences of autistic individuals and investing in inclusive interview methods, we can faithfully capture the experiences of autistic youth regardless of their communication and cognitive abilities. Being able to capture and amplify these diverse voices will facilitate the active involvement of autistic communities in research and clinical and policy decisions that impact them.
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31
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Pickles A, Wright N, Bedford R, Steiman M, Duku E, Bennett T, Georgiades S, Kerns CM, Mirenda P, Smith IM, Ungar WJ, Vaillancourt T, Waddell C, Zaidman‐Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. Predictors of language regression and its association with subsequent communication development in children with autism. J Child Psychol Psychiatry 2022; 63:1243-1251. [PMID: 35098539 PMCID: PMC9786608 DOI: 10.1111/jcpp.13565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Language regression, broadly defined as the loss of acquired language skills in early childhood, is a distinctive feature of autism. Little is known about the factors underlying regression or the prognosis of children who exhibit regression. We examine potential predictors of language regression and test its association with language development in a prospective longitudinal sample of children with autism spectrum disorder (ASD) from diagnosis to age 10 years. METHODS We analysed data from Pathways in ASD, a prospective longitudinal study of 421 children enrolled around the time of an autism diagnosis between 2 and 5 years. Autism Diagnostic Interview-Revised data were available for 408 children, of whom 90 (22%) were classified as having language regression. RESULTS Demographic and other health factors including caregiver education, family income, child sex, reported seizures, and age of enrolment did not differ between children with and without language regression. Children with language regression walked earlier and attained first words sooner than those without regression. However, both groups attained phrase speech at comparable ages. Those with regression exhibited greater delays in expressive and receptive communication over the follow-up period, although this effect was attenuated when accounting for baseline differences in motor and cognitive ability. Overall, those with language regression continued to exhibit expressive but not receptive communication delay compared to those without regression. Communication trajectories were heterogeneous to age 10 years, irrespective of regression status. CONCLUSIONS Although language regression can be alarming, our findings confirm that its occurrence does not necessarily foreshadow worse developmental outcomes relative to those without regression. Although a discrepancy in age-equivalent communication skills may persist, this can be expected to be of less practical importance with rising average levels of skills. Future studies need to account for the significant variability in language trajectories by considering factors beyond developmental regression.
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Affiliation(s)
- Andrew Pickles
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Nicola Wright
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | | | - Mandy Steiman
- Azrieli Centre for Autism ResearchMontreal Neurological HospitalMcGill UniversityMontrealQCCanada
| | | | | | | | | | - Pat Mirenda
- University of British ColumbiaVancouverBCCanada
| | | | - Wendy J. Ungar
- Hospital for Sick Children Research InstituteUniversity of TorontoTorontoONCanada
| | | | | | | | | | - Peter Szatmari
- Hospital for Sick Children Research InstituteUniversity of TorontoTorontoONCanada
| | - Mayada Elsabbagh
- Azrieli Centre for Autism ResearchMontreal Neurological HospitalMcGill UniversityMontrealQCCanada
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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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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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34
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Garon N, Zwaigenbaum L, Bryson SE, Smith IM, Brian J, Roncadin C, Vaillancourt T, Armstrong VL, Sacrey LR, Roberts W. Front Cover: Cover Image, Volume 25, Issue 5. Dev Sci 2022. [DOI: 10.1111/desc.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nicholas DB, Zulla RT, Conlon O, Dimitropoulos G, Urschel S, Rapoport A, Katz SL, Bruce A, West LJ, Belletrutti M, Cullen E, Zwaigenbaum L. Les effets de la pandémie de COVID-19 sur la santé mentale des enfants atteints de problèmes de santé physique ou d’incapacités, des familles et des professionnels de la santé. Paediatr Child Health 2022; 27:S115-S122. [PMID: 36092296 PMCID: PMC9455651 DOI: 10.1093/pch/pxac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Résumé
Objectifs
La pandémie de COVID-19 a influé sur la santé mentale de la population. Les familles des enfants qui ont des vulnérabilités en matière de santé ont été démesurément touchées par les politiques liées à la pandémie et les perturbations aux services, car elles s’appuient beaucoup sur le système de soins de santé et de services sociaux. Les chercheurs ont établi les répercussions de la pandémie de COVID-19 sur les enfants ayant des vulnérabilités en matière de santé physique et des incapacités, les familles et les professionnels de la santé.
Méthodologie
Des enfants ayant diverses vulnérabilités en matière de santé (transplantation cardiaque, affections respiratoires, anémie falciforme, trouble du spectre de l’autisme, troubles de santé mentale et approche de la fin de vie en raison d’une série de causes sous-jacentes), leurs parents et leurs professionnels de la santé ont participé à des entrevues semi-structurées. Les chercheurs ont utilisé des méthodes d’analyse qualitative et en ont extrait les thèmes liés aux effets et les recommandations en vue d’améliorer la pratique.
Résultats
Au total, 262 participants (30 enfants, 76 parents, 156 professionnels de la santé) ont été interviewés. Les enfants ont décrit leur solitude et leur isolement, les parents, leur épuisement, et les professionnels de la santé, la pression ressentie et un sentiment de détresse morale. Les thèmes reflétaient les effets de la pandémie sur la santé mentale des enfants, des familles et des professionnels de la santé, de même que les ressources insuffisantes pour soutenir la santé mentale, les influences organisationnelles et politiques qui ont façonné la prestation des services et les recommandations pour améliorer la prestation de ces services.
Conclusion
Les restrictions sanitaires imposées par la pandémie et les modifications aux soins ont eu de profondes répercussions sur la santé mentale des enfants qui ont des vulnérabilités en matière de santé, les familles et les professionnels de la santé. Les recommandations incluent la rédaction et l’adoption d’information ciblée sur la pandémie et la mise en œuvre de services de soutien en santé mentale. Ces résultats amplifient la nécessité de renforcer les capacités, y compris des stratégies proactives et la planification de mesures d’atténuation du risque dans l’éventualité d’une future pandémie.
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Affiliation(s)
- David B Nicholas
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Rosslynn T Zulla
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Olivia Conlon
- Université de Calgary, Faculté de travail social, Région du centre et du nord de l'Alberta, Edmonton (Alberta)Canada
| | - Gina Dimitropoulos
- Faculté de travail social, Université de Calgary, Calgary (Alberta)Canada
| | - Simon Urschel
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Adam Rapoport
- The Hospital for Sick Children, Toronto (Ontario)Canada.,Emily's House Children's Hospice, Toronto (Ontario)Canada.,Département de pédiatrie, Université de Toronto, Toronto (Ontario)Canada
| | - Sherri Lynne Katz
- Centre hospitalier pour enfants de l'est de l'Ontario, Ottawa (Ontario)Canada.,Département de pédiatrie, Université d'Ottawa, Ottawa (Ontario)Canada.,Institut de recherche du Centre hospitalier pour enfants de l'est de l'Ontario, Ottawa (Ontario)Canada
| | - Aisha Bruce
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Lori J West
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada
| | - Mark Belletrutti
- British Columbia Children's Hospital, Vancouver (Colombie-Britannique)Canada.,Départment de pédiatrie, Université de la Colombie-Britannique, Vancouver (Colombie-Britannique)Canada
| | - Emma Cullen
- Faculté de travail social, Université de Calgary, Calgary (Alberta)Canada
| | - Lonnie Zwaigenbaum
- Département de pédiatrie, Université de l'Alberta, Edmonton (Alberta)Canada.,Stollery Children's Hospital, Edmonton (Alberta)Canada.,Glenrose Rehabilitation Hospital, Edmonton (Alberta)Canada
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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)
| | -
- 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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Pecukonis M, Young GS, Brian J, Charman T, Chawarska K, Elsabbagh M, Iverson JM, Jeste S, Landa R, Messinger DS, Schwichtenberg A, Webb SJ, Zwaigenbaum L, Tager-Flusberg H. Early predictors of language skills at 3 years of age vary based on diagnostic outcome: A baby siblings research consortium study. Autism Res 2022; 15:1324-1335. [PMID: 35652157 PMCID: PMC9253079 DOI: 10.1002/aur.2760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [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: 12/17/2021] [Accepted: 05/11/2022] [Indexed: 11/08/2022]
Abstract
While previous work has identified the early predictors of language skills in infants at elevated familial risk (ER) and low familial risk (LR) for autism spectrum disorder (ASD), no studies to date have explored whether these predictors vary based on diagnostic outcome of ASD or no ASD. The present study used a large, multisite dataset to examine associations between a set of commonly studied predictor variables (infant gesture abilities, fine motor skills, nonverbal cognition, and maternal education level), measured at 12 months, and language skills, measured at 3 years, across three diagnostic outcome groups-infants with ASD ("ASD"), ER infants without ASD ("ER-no ASD"), and LR infants without ASD ("LR-no ASD"). Findings revealed that the predictors of language skills differed across groups, as gesture abilities were positively associated with language skills in the ER-no ASD group but negatively associated with language skills in the ASD group. Furthermore, maternal education level was positively associated with language skills in the ASD and LR-no ASD groups only. Variability in these early predictors may help explain why language skills are heterogeneous across the autism spectrum, and, with further study, may help clinicians identify those in need of additional and/or specialized intervention services that support language development. LAY SUMMARY: The present study identified predictors of language skills in infants with and without autism spectrum disorder (ASD). Maternal education level and 12-month gesture abilities predicted 3-year language skills in infants with ASD. Measuring these predictors early in life may help identify infants and families in need of additional and/or specialized intervention services that support language development.
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Affiliation(s)
| | - Gregory S. Young
- Department of Psychiatry and Behavioral Sciences, University of California Davis
| | | | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London
| | | | | | | | - Shafali Jeste
- Department of Pediatrics, Department of Neurology, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute
| | | | | | - Sara Jane Webb
- Psychiatry and Behavioral Sciences, University of Washington
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Pritchard-Wiart L, Thompson-Hodgetts S, McKillop AB, Rosychuk R, Mrklas K, Zwaigenbaum L, Zwicker J, Andersen J, King G, Firouzeh P. A multi-center, pragmatic, effectiveness-implementation (hybrid I) cluster randomized controlled trial to evaluate a child-oriented goal-setting approach in paediatric rehabilitation (the ENGAGE approach): a study protocol. BMC Pediatr 2022; 22:375. [PMID: 35764983 PMCID: PMC9241221 DOI: 10.1186/s12887-022-03381-4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Child-oriented goal-setting in pediatric rehabilitation may improve child motivation, engagement in therapy, child outcomes related to therapy, and service delivery efficiency. The primary objective of this trial is to determine the effectiveness of a principles-driven, child-focused approach to goal-setting, Enhancing Child Engagement in Goal-Setting (ENGAGE), on pediatric rehabilitation outcomes compared to usual practice. The three secondary objectives are to 1) compare costs and secondary outcomes of the ENGAGE approach to usual practice, 2) determine the influence of child, parent and therapist characteristics on child engagement in therapy and rehabilitation outcomes, and 3) identify barriers and facilitators to the implementation of ENGAGE. METHODS This research protocol describes a pragmatic, multi-site, cluster, effectiveness-implementation (hybrid type 1 design) randomized controlled trial. Therapists (n = 12 clusters of two therapists) at participating sites (n = 6) will be randomized to 1) the ENGAGE intervention group, or 2) usual care (control) using a computer-generated, permuted-block randomization sequence with site as a stratification variable designed by a statistician (RR). Each therapist will recruit four children 5-12 years old with neurodevelopmental conditions (n = 96), who will receive ENGAGE or usual care, according to therapist group allocation. ENGAGE therapists will be trained to use a 'toolbox' of evidence-driven, theory-informed principles to optimize child and parent motivation, engagement in the goal-setting process, and performance feedback strategies. Outcomes include goal performance (primary outcome), engagement in therapy, functional abilities, participation, and parent and child quality of life. Qualitative interviews with children, parents, ENGAGE therapists, and managers will explore challenges to implementation and potential mitigation strategies. Mixed effects multiple linear regression models will be developed for each outcome to assess group differences adjusted for clustering. A cost-effectiveness analysis will combine cost and a measure of effectiveness into an incremental cost-effectiveness ratio. Qualitative data on implementation will be analyzed inductively (thematic analysis) and deductively using established implementation science frameworks. DISCUSSION This study will evaluate the effects of collaborative goal-setting in pediatric rehabilitation and inform effective implementation of child-focused goal-setting practices. TRIAL REGISTRATION NCT05017363 (registered August 23, 2021 on ClinicalTrials.gov).
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Affiliation(s)
- Lesley Pritchard-Wiart
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, University of Alberta, 3-60 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
| | - Sandy Thompson-Hodgetts
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 3-20 Corbett Hall, Edmonton, AB, T6G 2G4, Canada
| | - Ashley B McKillop
- Faculty of Rehabilitation Medicine, University of Alberta, University of Alberta, 3-78 Corbett Hall, Edmonton, AB, T6G 2G4, Canada
| | - Rhonda Rosychuk
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 3-524 Edmonton Clinic Health Academy, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Kelly Mrklas
- System Innovation and Programs, Alberta Health Services and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Strategic Clinical Networks, Provincial Clinical Excellence, Alberta Health Services and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada, 1403 29th St NW, T2N 2T9
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 10230 111 Ave NW, Edmonton, AB, T5G 0B7, Canada
| | - Jennifer Zwicker
- Director School of Public Policy, Cumming School of Medicine, University of Calgary, NW University of Calgary, 135 376 Collegiate Blvd 2500 University Drive, NW, Calgary, AB, T2N 1N4, Canada
| | - John Andersen
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 10230 111 Ave NW, Edmonton, AB, T5G 0B7, Canada
| | - Gillian King
- Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, East York, ON, M4G 1R8, Canada
| | - Pegah Firouzeh
- Faculty of Rehabilitation Medicine, University of Alberta, University of Alberta, 3-70 Corbett Hall, Edmonton, T6G 2G4, Canada
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Yankowitz LD, Petrulla V, Plate S, Tunc B, Guthrie W, Meera SS, Tena K, Pandey J, Swanson MR, Pruett JR, Cola M, Russell A, Marrus N, Hazlett HC, Botteron K, Constantino JN, Dager SR, Estes A, Zwaigenbaum L, Piven J, Schultz RT, Parish-Morris J. Infants later diagnosed with autism have lower canonical babbling ratios in the first year of life. Mol Autism 2022; 13:28. [PMID: 35761377 PMCID: PMC9235227 DOI: 10.1186/s13229-022-00503-8] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Canonical babbling-producing syllables with a mature consonant, full vowel, and smooth transition-is an important developmental milestone that typically occurs in the first year of life. Some studies indicate delayed or reduced canonical babbling in infants at high familial likelihood for autism spectrum disorder (ASD) or who later receive an ASD diagnosis, but evidence is mixed. More refined characterization of babbling in the first year of life in infants with high likelihood for ASD is needed. METHODS Vocalizations produced at 6 and 12 months by infants (n = 267) taking part in a longitudinal study were coded for canonical and non-canonical syllables. Infants were categorized as low familial likelihood (LL), high familial likelihood diagnosed with ASD at 24 months (HL-ASD) or not diagnosed (HL-Neg). Language delay was assessed based on 24-month expressive and receptive language scores. Canonical babble ratio (CBR) was calculated by dividing the number of canonical syllables by the number of total syllables. Generalized linear (mixed) models were used to assess the relationship between group membership and CBR, controlling for site, sex, and maternal education. Logistic regression was used to assess whether canonical babbling ratios at 6 and 12 months predict 24-month diagnostic outcome. RESULTS No diagnostic group differences in CBR were detected at 6 months, but HL-ASD infants produced significantly lower CBR than both the HL-Neg and LL groups at 12 months. HL-Neg infants with language delay also showed reduced CBR at 12 months. Neither 6- nor 12-month CBR was significant predictors of 24-month diagnostic outcome (ASD versus no ASD) in logistic regression. LIMITATIONS Small numbers of vocalizations produced by infants at 6 months may limit the reliability of CBR estimates. It is not known if results generalize to infants who are not at high familial likelihood, or infants from more diverse racial and socioeconomic backgrounds. CONCLUSIONS Lower canonical babbling ratios are apparent by the end of the first year of life in ASD regardless of later language delay, but are also observed for infants with later language delay without ASD. Canonical babbling may lack specificity as an early marker when used on its own.
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Affiliation(s)
- L D Yankowitz
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
| | - V Petrulla
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - S Plate
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B Tunc
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - W Guthrie
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - S S Meera
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - K Tena
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - J Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M R Swanson
- Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
| | - J R Pruett
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - M Cola
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - A Russell
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - N Marrus
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - H C Hazlett
- University of North Carolina, Chapel Hill, NC, USA
| | - K Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - J N Constantino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - S R Dager
- University of Washington, Seattle, WA, USA
| | - A Estes
- University of Washington, Seattle, WA, USA
| | - L Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - J Piven
- University of North Carolina, Chapel Hill, NC, USA
| | - R T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J Parish-Morris
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Di Rezze B, Gentles SJ, Hidecker MJC, Zwaigenbaum L, Rosenbaum P, Duku E, Georgiades S, Roncadin C, Fang H, Tajik-Parvinchi D, Viveiros H. Adaptation, Content Validity and Reliability of the Autism Classification System of Functioning for Social Communication: From Toddlerhood to Adolescent-Aged Children with Autism. J Autism Dev Disord 2022; 52:5150-5161. [PMID: 35676381 DOI: 10.1007/s10803-022-05621-z] [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] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/26/2022]
Abstract
The Autism Classification System of Functioning: Social Communication (ACSF) describes social communication functioning levels. First developed for preschoolers with ASD, this study tests an expanded age range (2-to-18 years). The ACFS rates the child's typical and best (i.e., capacity) performance. Qualitative methods tested parent and clinician perspectives of the ACSF age expansion using content analysis. The ACSF was used twice by parents and professionals for the same child/youth. Reliabilities were assessed using weighted kappa. Content validity supported the ACSF's applicability, clarity, and usability. The ACSF adaptations did not change its original construct. Reliability were calculated from 90 parent and professional Time-1 and Time-2 ratings for children/youth (2.1-15.6 years). Results showed good-to-very good intra-rater agreement (typical) and good inter-rater agreement (capacity).
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Affiliation(s)
- Briano Di Rezze
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada.
| | - Stephen James Gentles
- Department of Community Health, Faculty of Human and Social Sciences, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, N2L 3C5, Canada
| | - Mary Jo Cooley Hidecker
- Department of Communication Science & Disorders, College of Health Sciences, University of Kentucky, 900 South Limestone, Lexington, KY, 40508, USA
| | - Lonnie Zwaigenbaum
- Autism Research Center, Glenrose Rehabilitation Hospital, Room E209, 10230 111 Avenue, Edmonton, AB, T5G 0B7, Canada
| | - Peter Rosenbaum
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada
| | - Eric Duku
- Department of Psychiatry & Behavioural Neurosciences, Faulty of Health Sciences, McMaster, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main Street West MIP 201A, Hamilton, ON, L8P 0A1, Canada
| | - Caroline Roncadin
- Ron Joyce Children's Health Centre, Hamilton Health Sciences, 325 Wellington Street North, Hamilton, ON, L8L 0A4, Canada
| | - Hanna Fang
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada
| | - Diana Tajik-Parvinchi
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada
| | - Helena Viveiros
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada
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42
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Tajik-Parvinchi D, Rosenbaum P, Hidecker MJC, Duku E, Zwaigenbaum L, Roncadin C, Georgiades S, Gentles S, Fang H, Di Rezze B. Construct Validity of the Autism Classification System of Functioning: Social Communication (ACSF:SC) Across Childhood and Adolescence. J Autism Dev Disord 2022:10.1007/s10803-022-05608-w. [PMID: 35666330 DOI: 10.1007/s10803-022-05608-w] [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] [Accepted: 05/07/2022] [Indexed: 11/24/2022]
Abstract
This study examined the construct validity of the Autism Classification System of Functioning: Social Communication (ACSF). Participants included 145 parents of children with autism (2-19 years). The degree of convergent and discriminant validity between parent reported ACSF and subscales from Social Responsiveness Scale 2nd edition and Behavior Assessment System for Children, 3rd Edition were examined against a priori hypotheses. We examined construct validity in the entire sample as well as in specific age cohorts. Our findings suggest that ACSF can provide a valid classification system of social communication ability in children with autism 2-19 years of age, and its two subscales may be used to examine different aspects of social communication ability.
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Affiliation(s)
- Diana Tajik-Parvinchi
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada.
- School of Rehabilitation Sciences, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, Room 436, 1400 Main St. W, L8S 1C7, Hamilton, ON, Canada.
| | - Peter Rosenbaum
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 408, L8S 1C7, Hamilton, Ontario, Canada
| | - Mary Jo Cooley Hidecker
- Department of Communication Science & Disorders, College of Health Sciences, University of Kentucky, 900 South Limestone, 40508, Lexington, KY, USA
| | - Eric Duku
- Department of Psychiatry & Behavioural Neurosciences, Faulty of Health Sciences, 1280 Main Street West, L8S 4L8, McMaster, Hamilton, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Center, Glenrose Rehabilitation Hospital, Room E209, 10230 111 Avenue, T5G 0B7, Edmonton, Alberta, Canada
| | - Caroline Roncadin
- Ron Joyce Children's Health Centre, Hamilton Health Sciences, 325 Wellington Street North, L8L 0A4, Hamilton, Ontario, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main Street West, MIP 201A, L8P 0A1, Hamilton, Ontario, Canada
| | - Stephen Gentles
- Department of Community Health, Faculty of Human and Social Sciences, Wilfrid Laurier University, 75 University Avenue West, N2L 3C5, Waterloo, Ontario, Canada
| | - Hanna Fang
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada
| | - Briano Di Rezze
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada
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Nicholas DB, Zulla RT, Conlon O, Dimitropoulos G, Urschel S, Rapoport A, Katz SL, Bruce A, West LJ, Belletrutti M, Cullen E, Zwaigenbaum L. Mental health impacts of the COVID-19 pandemic on children with underlying health and disability issues, and their families and health care providers. Paediatr Child Health 2022; 27:S33-S39. [PMID: 35620553 PMCID: PMC9126279 DOI: 10.1093/pch/pxab103] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/21/2021] [Indexed: 11/14/2022] Open
Abstract
Objectives The COVID-19 pandemic has impacted mental health at a population level. Families of children with health vulnerabilities have been disproportionately affected by pandemic-related policies and service disruptions as they substantially rely on the health and social care system. We elicited the impact of the COVID-19 pandemic on children with health and disability-related vulnerabilities, their families, and their health care providers (HCPs). Methods Children with diverse health vulnerabilities (cardiac transplantation, respiratory conditions, sickle cell disease, autism spectrum disorder, mental health issues, and nearing the end of life due to a range of underlying causes), as well as their parents and HCPs, participated in semi-structured interviews. Data were analyzed using qualitative content analysis in determining themes related to impact and recommendations for practice improvement. Results A total of 262 participants (30 children, 76 parents, 156 HCPs) were interviewed. Children described loneliness and isolation; parents described feeling burnt out; and HCPs described strain and a sense of moral distress. Themes reflected mental health impacts on children, families, and HCPs, with insufficient resources to support mental health; organizational and policy influences that shaped service delivery; and recommendations to enhance service delivery. Conclusion Children with health vulnerabilities, their families and HCPs incurred profound mental health impacts due to pandemic-imposed public health restrictions and care shifts. Recommendations include the development and application of targeted pandemic information and mental health supports. These findings amplify the need for capacity building, including proactive strategies and mitigative planning in the event of a future pandemic.
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Affiliation(s)
- David B Nicholas
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Rosslynn T Zulla
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Olivia Conlon
- University of Calgary, Faculty of Social Work, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | | | - Simon Urschel
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Adam Rapoport
- The Hospital for Sick Children, Toronto, Ontario, Canada.,Emily's House Children's Hospice, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sherri Lynne Katz
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Aisha Bruce
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Lori J West
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Mark Belletrutti
- British Columbia Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emma Cullen
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada.,Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
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Ameis SH, Haltigan JD, Lyon RE, Sawyer A, Mirenda P, Kerns CM, Smith IM, Vaillancourt T, Volden J, Waddell C, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Ungar WJ, Zaidman‐Zait A, Lai M, Szatmari P. Middle-childhood executive functioning mediates associations between early-childhood autism symptoms and adolescent mental health, academic and functional outcomes in autistic children. J Child Psychol Psychiatry 2022; 63:553-562. [PMID: 34382216 PMCID: PMC9291328 DOI: 10.1111/jcpp.13493] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Executive functioning (EF) varies in children with autism spectrum disorder (ASD) and is associated with clinical symptoms, academic, and adaptive functioning. Here, we examined whether middle-childhood EF mediates associations between early-childhood autism symptoms and adolescent outcomes in children with ASD. METHODS The Pathways in ASD Cohort comprising children recruited at the time of ASD diagnosis (at 2-4 years-of-age) and followed prospectively across eight subsequent timepoints over ~10 years was used. A subset of Pathways participants (n = 250) with Behavior Rating Inventory of Executive Function (BRIEF)-Parent Form data from at least one timepoint when participants were school-aged was analyzed. A mediation framework was used to examine whether BRIEF-measured EF across age 7-10 years (middle-childhood) mediated associations between early-childhood autism symptoms (measured using the parent-report Social Responsiveness Scale across age 2-6 years) and clinical, academic, and functional outcomes, indexed at age >10-11.8 years (early-adolescence) using the Child Behavior Checklist (CBCL)-Internalizing and Externalizing Scales, Academic Performance from the Teacher's Report Form, and Vineland Adaptive Behavior Scales. Models were rerun substituting clinician-rated and teacher-rated measures, where possible. RESULTS Mediation models indicated a significant indirect effect of middle-childhood EF on associations between early-childhood autism symptoms and externalizing behavior, academic performance, or adaptive functioning in early adolescence; kappa squared (κ2 ) effect sizes ranged from large to small. Model findings were stable across raters. Middle-childhood EF did not mediate associations between early-childhood autism symptoms and adolescent internalizing behavior. CONCLUSIONS Among children with an ASD diagnosis, middle-childhood EF may be one pathway through which early-childhood autism symptoms influence a variety of outcomes in early-adolescence. An experimental study targeting middle-childhood EF to improve adolescent academic, emotional/behavioral, and adaptive functioning is needed to evaluate the clinical meaningfulness of these findings.
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Affiliation(s)
- Stephanie H. Ameis
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
| | - John D. Haltigan
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of Applied Psychology and Human DevelopmentUniversity of TorontoTorontoONCanada
| | - Rachael E. Lyon
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada
| | - Amanda Sawyer
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - Pat Mirenda
- Department of Educational and Counselling Psychology and Special EducationUniversity of British ColumbiaVancouverBCCanada
| | - Connor M. Kerns
- Department of PsychologyUniversity of British ColumbiaVancouverBCCanada
| | - Isabel M. Smith
- Department of PediatricsDalhousie UniversityHalifaxNSCanada,Autism Research CentreDalhousie University and IWK Health CentreHalifaxNSCanada
| | | | - Joanne Volden
- Faculty of Rehabilitation MedicineUniversity of AlbertaEdmontonABCanada
| | - Charlotte Waddell
- Children's Health Policy CentreFaculty of Health SciencesSimon Fraser UniversityVancouverBCCanada
| | - Lonnie Zwaigenbaum
- Department of PediatricsUniversity of AlbertaEdmontonABCanada,Autism Research CentreEdmontonABCanada
| | - Teresa Bennett
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Eric Duku
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Mayada Elsabbagh
- Montreal Neurological InstituteMcGill UniversityMontrealQCCanada
| | - Stelios Georgiades
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Wendy J. Ungar
- Child Health Evaluative SciencesThe Hospital for Sick Children Research InstituteTorontoONCanada,Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoONCanada
| | - Anat Zaidman‐Zait
- Department of School Counseling and Special EducationConstantiner School of EducationTel Aviv UniversityTel AvivIsrael,School of Population and Public HealthFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Meng‐Chuan Lai
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
| | - Peter Szatmari
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
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Sacrey LAR, Zwaigenbaum L, Bryson SE, Brian JA, Smith IM, Garon N, Vaillancourt T, Roncadin C. Temperament in Infancy Predicts Internalizing and Externalizing Problem Behavior at Age 5 in Children With an Increased Likelihood of Autism Spectrum Disorder. Front Psychol 2022; 13:816041. [PMID: 35519644 PMCID: PMC9062223 DOI: 10.3389/fpsyg.2022.816041] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Differences in temperament have been linked to later mental health. Children with autism spectrum disorder (ASD) have an increased likelihood of experiencing such problems, including anxiety, depression, attention deficit/hyperactivity disorder, and oppositional defiant disorder; yet, relations between early temperament and later mental health are not well understood. In this paper, we assess the relationship between temperament in infancy and internalizing and externalizing behavior at age 5, in 178 children at an increased likelihood of being diagnosed with ASD (i.e., younger siblings of children with ASD). Temperament was assessed using the parent-reported Infant Behavior Questionnaire (IBQ) at 6 and 12 months of age and the Toddler Behavior Assessment Questionnaire-Revised (TBAQ-R) at 24 months of age. Mental health problems were assessed using the parent-reported Child Behavior Checklist (CBCL) at age 5. The data were analyzed using hierarchical multiple regressions, with individual temperament subscale scores as single predictor variables (Subscale Score) or temperament profiles using confirmatory factor analyses (Person-Centered Profile) in the first block, Autism Diagnostic Observation Schedule total severity scores at age 3 in the second block, and expressive and receptive language scores (from Mullen Scales of Early Learning) at age 3 in the third block for each model. Three main findings were: (1) 4 of 6 IBQ subscales at both 6 and 12 months significantly predicted internalizing and externalizing problems at age 5; (2) 9 and 8 of 13 TBAQ-R subscales at 24 months significantly predicted internalizing and externalizing problems, respectively, at age 5; and (3) a "sticky attention" temperament profile significantly predicted internalizing problems, whereas a "low-focused" profile significantly predicted externalizing problems, both at age 5. The results of this study support the supposition that temperament is a trans-diagnostic risk factor for later mental health conditions. Exploring temperament profiles and trajectories may illuminate early avenues for prevention in siblings of children with ASD who are at an increased likelihood of experiencing mental health problems, regardless of ASD diagnostic status.
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Affiliation(s)
- Lori-Ann R. Sacrey
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Susan E. Bryson
- Dalhousie University, IWK Health Centre, Halifax, NS, Canada
| | - Jessica A. Brian
- Bloorview Research Institute, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Isabel M. Smith
- Dalhousie University, IWK Health Centre, Halifax, NS, Canada
| | - Nancy Garon
- Department of Psychology, Mount Allison University, Sackville, NB, Canada
| | | | - Caroline Roncadin
- McMaster Children’s Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
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46
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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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47
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Kamali M, Sivapalan S, Kata A, Kim N, Shanmugalingam N, Duku E, Zwaigenbaum L, Georgiades S. Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario. BMC Health Serv Res 2022; 22:426. [PMID: 35361202 PMCID: PMC8973535 DOI: 10.1186/s12913-022-07789-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/31/2021] [Accepted: 03/16/2022] [Indexed: 04/13/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence worldwide. Early identification of ASD through developmental screening is critical for early intervention and improved behavioural outcomes in children. However due to long wait times, delays in diagnosis continue to occur, particularly among minority populations who are faced with existing barriers in access to care. A novel Mobile Developmental Outreach Clinic (M-DOC) was implemented to deliver culturally sensitive screening and assessment practices to increase access to developmental health services, reduce wait times in diagnoses, and aid in equitable access to intervention programs among vulnerable populations in Ontario. Methods This study applied two evaluation frameworks (process and outcome evaluation) to determine whether the delivery model was implemented as intended, and if the program achieved its targeted goals. A mixed-methods design was undertaken to address the study objectives. Results Between September 2018–February 2020, M-DOC reached 227 families with developmental health concerns for their child, while successfully targeting the intended population and achieving its goals. The mean age of the child-in-need at intake was 31.6 months (SD 9.9), and 70% of the sample were male. The program’s success was attributed to the use of cultural liaisons to break cultural and linguistic barriers, the creation of multiple points of access into the diagnosis pathway, and delivery of educational workshops in local communities to raise awareness and knowledge of autism spectrum disorder. Conclusions The findings underscore the need for community-based intervention programs that focus on cultural barriers to accessing health services. The model of delivery of the M-DOC programs highlights the opportunity for other programs to adopt a similar mobile outreach clinic approach as a means to increase access to services, particularly in targeting hard-to-reach and vulnerable populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07789-7.
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Affiliation(s)
- Mahdis Kamali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada. .,Offord Centre for Child Studies, Hamilton, Canada.
| | | | - Anna Kata
- Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Nicole Kim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | - Eric Duku
- Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Stelios Georgiades
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.,McMaster Children's Hospital, Hamilton, Canada
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48
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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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49
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Plate S, Yankowitz L, Resorla L, Swanson MR, Meera SS, Estes A, Marrus N, Cola M, Petrulla V, Faggen A, Pandey J, Paterson S, Pruett JR, Hazlett H, Dager S, John TS, Botteron K, Zwaigenbaum L, Piven J, Schultz RT, Parish-Morris J. Infant vocalizing and phenotypic outcomes in autism: Evidence from the first 2 years. Child Dev 2022; 93:468-483. [PMID: 34708871 PMCID: PMC9112828 DOI: 10.1111/cdev.13697] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Infant vocalizations are early-emerging communicative markers shown to be atypical in autism spectrum disorder (ASD), but few longitudinal, prospective studies exist. In this study, 23,850 infant vocalizations from infants at low (LR)- and high (HR)-risk for ASD (HR-ASD = 23, female = 3; HR-Neg = 35, female = 13; LR = 32, female = 10; 80% White; collected from 2007 to 2017 near Philadelphia) were analyzed at 6, 12, and 24 months. At 12 months, HR-ASD infants produced fewer vocalizations than HR-Neg infants. From 6 to 24 months, HR-Neg infants demonstrated steeper vocalization growth compared to HR-ASD and LR infants. Finally, among HR infants, vocalizing at 12 months was associated with language, social phenotype, and diagnosis at age 2. Infant vocalizing is an objective behavioral marker that could facilitate earlier detection of ASD.
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Affiliation(s)
- Samantha Plate
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lisa Yankowitz
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Meredith Cola
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Victoria Petrulla
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Aubrey Faggen
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah Paterson
- The James S. McDonnel Foundation, Saint Louis, Missouri, USA
| | - John R. Pruett
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Heather Hazlett
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Stephen Dager
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Tanya St. John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Kelly Botteron
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, USA
| | | | - Joseph Piven
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Julia Parish-Morris
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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50
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Garon N, Zwaigenbaum L, Bryson SE, Smith IM, Brian J, Roncadin C, Vaillancourt T, Armstrong VL, Sacrey LAR, Roberts W. Precursors of Self-Regulation in Infants at Elevated Likelihood for Autism Spectrum Disorder. Dev Sci 2022; 25:e13247. [PMID: 35174584 DOI: 10.1111/desc.13247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/28/2021] [Revised: 11/19/2021] [Accepted: 02/04/2022] [Indexed: 12/01/2022]
Abstract
Research concerning temperament in children and adults with autism spectrum disorder (ASD) has suggested a consistent profile of low positive affect, high negative affect, and low regulation (Visser et al., 2016). One area receiving less attention is individual differences among children diagnosed with ASD. The primary objective of this study was to use a person-centered approach to explore heterogeneity of early temperament precursors of regulation in a large sample of infants with elevated familial likelihood of ASD. Early precursors of regulation included temperament assessed at 6, 12, and 24 months whereas outcome measures were diagnosis of ASD, cognitive ability and adaptive behavior at 36 months. Participants included 176 low-likelihood and 473 elevated-likelihood infants, 129 of whom were diagnosed with ASD at 3 years. Results supported a three-profile solution: a well-regulated profile (high positive affect and high attentional focus and shifting), a low attention focus profile (higher attentional shifting compared to attentional focus), and a low attention shifting profile (higher attentional focus compared to attentional shifting). A higher proportion of children diagnosed with ASD were classified into the low attention shifting profile. Furthermore, children with the well-regulated profile were differentiated from the other profiles by a pattern of higher social competence and lower dysregulation whereas children with the low attention focus profile were distinguished from the other profiles by higher cognitive ability at 3 years. The findings indicate that the combination of early positive affect with attention measures may provide an enhanced tool for prediction of self-regulation and later outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Nancy Garon
- Mount Allison University, Sackville, NB, Canada
| | - Lonnie Zwaigenbaum
- Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada.,Department of Pediatrics, Autism Research Centre, Edmonton, AB, Canada
| | - Susan E Bryson
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | - Isabel M Smith
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | - Jessica Brian
- Bloorview Research Department of Pediatrics, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Caroline Roncadin
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | | | | | - Lori-Ann R Sacrey
- Departments of Pediatrics, University of Alberta, Edmonton, AB, Canada.,Department of Pediatrics, Autism Research Centre, Edmonton, AB, Canada
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