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Shic F, Barney EC, Naples AJ, Dommer KJ, Chang SA, Li B, McAllister T, Atyabi A, Wang Q, Bernier R, Dawson G, Dziura J, Faja S, Jeste SS, Murias M, Johnson SP, Sabatos-DeVito M, Helleman G, Senturk D, Sugar CA, Webb SJ, McPartland JC, Chawarska K. The Selective Social Attention task in children with autism spectrum disorder: Results from the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) feasibility study. Autism Res 2023; 16:2150-2159. [PMID: 37749934 PMCID: PMC11003770 DOI: 10.1002/aur.3026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/25/2023] [Indexed: 09/27/2023]
Abstract
The Selective Social Attention (SSA) task is a brief eye-tracking task involving experimental conditions varying along socio-communicative axes. Traditionally the SSA has been used to probe socially-specific attentional patterns in infants and toddlers who develop autism spectrum disorder (ASD). This current work extends these findings to preschool and school-age children. Children 4- to 12-years-old with ASD (N = 23) and a typically-developing comparison group (TD; N = 25) completed the SSA task as well as standardized clinical assessments. Linear mixed models examined group and condition effects on two outcome variables: percent of time spent looking at the scene relative to scene presentation time (%Valid), and percent of time looking at the face relative to time spent looking at the scene (%Face). Age and IQ were included as covariates. Outcome variables' relationships to clinical data were assessed via correlation analysis. The ASD group, compared to the TD group, looked less at the scene and focused less on the actress' face during the most socially-engaging experimental conditions. Additionally, within the ASD group, %Face negatively correlated with SRS total T-scores with a particularly strong negative correlation with the Autistic Mannerism subscale T-score. These results highlight the extensibility of the SSA to older children with ASD, including replication of between-group differences previously seen in infants and toddlers, as well as its ability to capture meaningful clinical variation within the autism spectrum across a wide developmental span inclusive of preschool and school-aged children. The properties suggest that the SSA may have broad potential as a biomarker for ASD.
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Affiliation(s)
- Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Erin C. Barney
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adam J. Naples
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kelsey J. Dommer
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Shou An Chang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Beibin Li
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, Washington, USA
| | - Takumi McAllister
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adham Atyabi
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Computer Science, University of Colorado - Colorado Springs, Colorado Springs, Colorado, USA
| | - Quan Wang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Xi’an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi’an, China
| | - Raphael Bernier
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, Seattle, Washington, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - James Dziura
- Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Susan Faja
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Shafali Spurling Jeste
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, California, USA
- Division of Neurology, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Michael Murias
- Department of Medical Social Sciences, Northwestern University, Evanston, Illinois, USA
| | - Scott P. Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Gerhard Helleman
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles, Los Angeles, California, USA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los Angeles, Los Angeles, California, USA
| | - Sara Jane Webb
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, Seattle, Washington, USA
| | - James C. McPartland
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Yuan A, Sabatos-DeVito M, Bey AL, Major S, Carpenter KL, Franz L, Howard J, Vermeer S, Simmons R, Troy J, Dawson G. Automated movement tracking of young autistic children during free play is correlated with clinical features associated with autism. Autism 2023; 27:2530-2541. [PMID: 37151032 DOI: 10.1177/13623613231169546] [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: 05/09/2023]
Abstract
LAY ABSTRACT Play-based observations allow researchers to observe autistic children across a wide range of ages and skills. We recorded autistic children playing with toys in the center of a room and at a corner table while a caregiver remained seated off to the side and used video tracking technology to track children's movement and location. We examined how time children spent in room regions and whether or not they approached each region during play related to their cognitive, social, communication, and adaptive skills to determine if tracking child movement and location can meaningfully demonstrate clinical variation among autistic children representing a range of ages and skills. One significant finding was that autistic children who spent more time in the toy-containing center of the room had higher cognitive and language abilities, whereas those who spent less time in the center had higher levels of autism-related behaviors. In contrast, children who spent more time in the caregiver region had lower daily living skills and those who were quicker to approach the caregiver had lower adaptive behavior and language skills. These findings support the use of movement tracking as a complementary method of measuring clinical differences among autistic children. Furthermore, over 90% of autistic children representing a range of ages and skills in this study provided analyzable play observation data, demonstrating that this method allows autistic children of all levels of support needs to participate in research and demonstrate their social, communication, and attention skills without wearing any devices.
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Bey AL, Sabatos-DeVito M, Carpenter KLH, Franz L, Howard J, Vermeer S, Simmons R, Troy JD, Dawson G. Automated Video Tracking of Autistic Children's Movement During Caregiver-Child Interaction: An Exploratory Study. J Autism Dev Disord 2023:10.1007/s10803-023-06107-2. [PMID: 37642871 DOI: 10.1007/s10803-023-06107-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 08/31/2023]
Abstract
Objective, quantitative measures of caregiver-child interaction during play are needed to complement caregiver or examiner ratings for clinical assessment and tracking intervention responses. In this exploratory study, we examined the feasibility of using automated video tracking, Noldus EthoVision XT, to measure 159 2-to-7-year-old autistic children's patterns of movement during play-based, caregiver-child interactions and examined their associations with standard clinical measures and human observational coding of caregiver-child joint engagement. Results revealed that autistic children who exhibited higher durations and velocity of movement were, on average, younger, had lower cognitive abilities, greater autism-related features, spent less time attending to the caregiver, and showed lower levels of joint engagement. After adjusting for age and nonverbal cognitive abilities, we found that children who remained in close proximity to their caregiver were more likely to engage in joint engagement that required support from the caregiver. These findings suggest that video tracking offers promise as a scalable, quantitative, and relevant measure of autism-related behaviors.
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Affiliation(s)
- Alexandra L Bey
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kimberly L H Carpenter
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Lauren Franz
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Institute for Global Health, Duke University, Durham, NC, USA
| | - Jill Howard
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Saritha Vermeer
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Ryan Simmons
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Duke University, Durham, NC, USA
| | - Jesse D Troy
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Duke University, Durham, NC, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
- Marcus Center for Cellular Cures, Duke University School of Medicine, Duke University, Durham, NC, USA.
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Faja S, Sabatos-DeVito M, Sridhar A, Kuhn JL, Nikolaeva JI, Sugar CA, Webb SJ, Bernier RA, Sikich L, Hellemann G, Senturk D, Naples AJ, Shic F, Levin AR, Seow HA, Dziura JD, Jeste SS, Chawarska K, Nelson CA, Dawson G, McPartland JC. Evaluation of clinical assessments of social abilities for use in autism clinical trials by the autism biomarkers consortium for clinical trials. Autism Res 2023; 16:981-996. [PMID: 36929131 PMCID: PMC10192100 DOI: 10.1002/aur.2905] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/11/2023] [Indexed: 03/18/2023]
Abstract
Clinical trials in autism spectrum disorder (ASD) often rely on clinician rating scales and parent surveys to measure autism-related features and social behaviors. To aid in the selection of these assessments for future clinical trials, the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) directly compared eight common instruments with respect to acquisition rates, sensitivity to group differences, equivalence across demographic sub-groups, convergent validity, and stability over a 6-week period. The sample included 280 children diagnosed with ASD (65 girls) and 119 neurotypical children (36 girls) aged from 6 to 11 years. Full scale IQ for ASD ranged from 60 to 150 and for neurotypical ranged from 86 to 150. Instruments measured clinician global assessment and autism-related behaviors, social communication abilities, adaptive function, and social withdrawal behavior. For each instrument, we examined only the scales that measured social or communication functioning. Data acquisition rates were at least 97.5% at T1 and 95.7% at T2. All scales distinguished diagnostic groups. Some scales significantly differed by participant and/or family demographic characteristics. Within the ASD group, most clinical instruments exhibited weak (≥ |0.1|) to moderate (≥ |0.4|) intercorrelations. Short-term stability was moderate (ICC: 0.5-0.75) to excellent (ICC: >0.9) within the ASD group. Variations in the degree of stability may inform viability for different contexts of use, such as identifying clinical subgroups for trials versus serving as a modifiable clinical outcome. All instruments were evaluated in terms of their advantages and potential concerns for use in clinical trials.
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Affiliation(s)
- Susan Faja
- Department of Pediatrics, Harvard Medical School. Boston MA. USA
- Boston Children’s Hospital. Boston MA. USA
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University. Durham NC. USA
- Department of Psychiatry & Behavioral Sciences, Duke University. Durham NC. USA
| | | | - Jocelyn L. Kuhn
- Department of Pediatrics, Boston University School of Medicine. Boston MA. USA
| | - Julia I. Nikolaeva
- Department of Communication Sciences and Disorders, Northwestern University. Evanston IL. USA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los Angeles. Los Angeles CA. USA
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles. Los Angeles CA. USA
| | - Sara Jane Webb
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute. Seattle WA. USA
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine. Seattle WA. USA
| | - Raphael A. Bernier
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine. Seattle WA. USA
| | - Linmarie Sikich
- Department of Psychiatry & Behavioral Sciences, Duke University. Durham NC. USA
| | - Gerhard Hellemann
- Department of Biostatistics, University of Alabama at Birmingham. Birmingham AB. USA
| | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles. Los Angeles CA. USA
| | - Adam J. Naples
- Yale Child Study Center, Yale University. New Haven CT. USA
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute. Seattle WA. USA
- Department of General Pediatrics, University of Washington School of Medicine. Seattle WA. USA
| | - April R. Levin
- Department of Neurology, Boston Children’s Hospital. Boston MA. USA
- Harvard Medical School. Boston MA. USA
| | - Helen A. Seow
- Yale Center for Clinical Investigation, Yale University. New Haven CT. USA
| | - James D. Dziura
- Department of Emergency Medicine, Yale University. New Haven CT. USA
| | - Shafali S. Jeste
- Department of Pediatrics and Neurology, Children’s Hospital, Los Angeles. Los Angeles CA. USA
- USC Keck School of Medicine. Los Angeles CA. USA
| | | | - Charles A. Nelson
- Department of Pediatrics, Harvard Medical School. Boston MA. USA
- Boston Children’s Hospital. Boston MA. USA
- Graduate School of Education, Harvard University. Boston MA. USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University. Durham NC. USA
- Department of Psychiatry & Behavioral Sciences, Duke University. Durham NC. USA
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Isaev DY, Sabatos-DeVito M, Di Martino JM, Carpenter K, Aiello R, Compton S, Davis N, Franz L, Sullivan C, Dawson G, Sapiro G. Computer Vision Analysis of Caregiver-Child Interactions in Children with Neurodevelopmental Disorders: A Preliminary Report. J Autism Dev Disord 2023:10.1007/s10803-023-05973-0. [PMID: 37103659 PMCID: PMC10603206 DOI: 10.1007/s10803-023-05973-0] [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: 03/20/2023] [Indexed: 04/28/2023]
Abstract
We report preliminary results of computer vision analysis of caregiver-child interactions during free play with children diagnosed with autism (N = 29, 41-91 months), attention-deficit/hyperactivity disorder (ADHD, N = 22, 48-100 months), or combined autism + ADHD (N = 20, 56-98 months), and neurotypical children (NT, N = 7, 55-95 months). We conducted micro-analytic analysis of 'reaching to a toy,' as a proxy for initiating or responding to a toy play bout. Dyadic analysis revealed two clusters of interaction patterns, which differed in frequency of 'reaching to a toy' and caregivers' contingent responding to the child's reach for a toy by also reaching for a toy. Children in dyads with higher caregiver responsiveness had less developed language, communication, and socialization skills. Clusters were not associated with diagnostic groups. These results hold promise for automated methods of characterizing caregiver responsiveness in dyadic interactions for assessment and outcome monitoring in clinical trials.
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Affiliation(s)
- Dmitry Yu Isaev
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - J Matias Di Martino
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA
| | - Kimberly Carpenter
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Rachel Aiello
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Scott Compton
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Naomi Davis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Lauren Franz
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Connor Sullivan
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Guillermo Sapiro
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA.
- Departments of Biomedical Engineering, Computer Science, and Mathematics, Duke University, Durham, NC, USA.
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Wall CA, Sabatos-DeVito M, Franz L, Howard J, Major S, Bey A, Dawson G. Eye-tracking measures of social versus nonsocial attention are related to level of social engagement during naturalistic caregiver-child interactions in autistic children. Autism Res 2023; 16:1052-1062. [PMID: 36942384 DOI: 10.1002/aur.2920] [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] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
Eye-tracking (ET) measures indexing social attention have been proposed as sensitive measures related to autism, but less is known about the relationship between social and nonsocial attention and naturalistic measures of social engagement and whether sex moderates this relationship. This study investigated ET measures of social attention as predictors of social engagement during a naturalistic caregiver-child interaction (CCI). Participants included 132, 2-7-year-old autistic children (77% male) and their caregivers. Participants engaged in a CCI and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. Pearson correlations and multiple regression analyzes revealed that ET measures correlated with social engagement behaviors, including degree of attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement. Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor's mouth were more likely to engage in coordinated play with and without language. Sex moderated the relationship between time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Overall, ET measures of social and nonsocial attention correlated with the level of social engagement during naturalistic play, with some sex differences. Eye-tracking measures that predict interaction patterns may provide insight into promoting social engagement between caregivers and their autistic children and can inform outcome monitoring and intervention development.
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Affiliation(s)
- Carla A Wall
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Samantha Major
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Alexandra Bey
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
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7
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Webb SJ, Naples AJ, Levin AR, Hellemann G, Borland H, Benton J, Carlos C, McAllister T, Santhosh M, Seow H, Atyabi A, Bernier R, Chawarska K, Dawson G, Dziura J, Faja S, Jeste S, Murias M, Nelson CA, Sabatos-DeVito M, Senturk D, Shic F, Sugar CA, McPartland JC. The Autism Biomarkers Consortium for Clinical Trials: Initial Evaluation of a Battery of Candidate EEG Biomarkers. Am J Psychiatry 2023; 180:41-49. [PMID: 36000217 PMCID: PMC10027395 DOI: 10.1176/appi.ajp.21050485] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Numerous candidate EEG biomarkers have been put forward for use in clinical research on autism spectrum disorder (ASD), but biomarker development has been hindered by limited attention to the psychometric properties of derived variables, inconsistent results across small studies, and variable methodology. The authors evaluated the basic psychometric properties of a battery of EEG assays for their potential suitability as biomarkers in clinical trials. METHODS This was a large, multisite, naturalistic study in 6- to 11-year-old children who either had an ASD diagnosis (N=280) or were typically developing (N=119). The authors evaluated an EEG battery composed of well-studied assays of resting-state activity, face perception (faces task), biological motion perception, and visual evoked potentials (VEPs). Biomarker psychometrics were evaluated in terms of acquisition rates, construct performance, and 6-week stability. Preliminary evaluation of use was explored through group discrimination and phenotypic correlations. RESULTS Three assays (resting state, faces task, and VEP) show promise in terms of acquisition rates and construct performance. Six-week stability values in the ASD group were moderate (intraclass correlations ≥0.66) for the faces task latency of the P1 and N170, the VEP amplitude of N1 and P1, and resting alpha power. Group discrimination and phenotype correlations were primarily observed for the faces task P1 and N170. CONCLUSIONS In the context of a large-scale, rigorous evaluation of candidate EEG biomarkers for use in ASD clinical trials, neural response to faces emerged as a promising biomarker for continued evaluation. Resting-state activity and VEP yielded mixed results. The study's biological motion perception assay failed to display construct performance. The results provide information about EEG biomarker performance that is relevant for the next stage of biomarker development efforts focused on context of use.
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Affiliation(s)
- Sara Jane Webb
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Adam J Naples
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - April R Levin
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Gerhard Hellemann
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Heather Borland
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Jessica Benton
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Carter Carlos
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Takumi McAllister
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Megha Santhosh
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Helen Seow
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Adham Atyabi
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Raphael Bernier
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Katarzyna Chawarska
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Geraldine Dawson
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - James Dziura
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Susan Faja
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Shafali Jeste
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Michael Murias
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Charles A Nelson
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Maura Sabatos-DeVito
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Damla Senturk
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Frederick Shic
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - Catherine A Sugar
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
| | - James C McPartland
- Center for Child Health, Behavior, and Development and Seattle Children's Research Institute, Seattle (Webb, Borland, Benton, Santhosh, Shic); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Webb, Bernier); Yale Child Study Center (Naples, Carlos, McAllister, Chawarska, McPartland), Yale Center for Clinical Investigation (Seow), and Department of Emergency Medicine (Dziura), Yale University, New Haven, Conn.; Department of Neurology, Boston Children's Hospital, Boston (Levin); Department of Neurology, Harvard Medical School, Boston (Levin); Department of Psychiatry and Biobehavioral Sciences (Hellemann, Jeste, Senturk, Sugar) and Department of Biostatistics (Senturk, Sugar), University of California Los Angeles, Los Angeles; Department of Computer Science, University of Colorado, Colorado Springs (Atyabi); Duke Center for Autism and Brain Development (Dawson, Sabatos-DeVito) and Department of Psychiatry and Behavioral Sciences (Dawson), Duke University, Durham, N.C.; Department of Pediatrics, Harvard University, Boston (Faja, Nelson); Division of Developmental Medicine, Boston Children's Hospital, Boston (Faja, Nelson); Department of Medical Social Sciences, Northwestern University, Chicago (Murias); Graduate School of Education, Harvard University, Boston (Nelson); Department of Pediatrics, University of Washington, Seattle (Shic)
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8
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Carpenter KLH, Davis NO, Spanos M, Sabatos-DeVito M, Aiello R, Baranek GT, Compton SN, Egger HL, Franz L, Kim SJ, King BH, Kolevzon A, McDougle CJ, Sanders K, Veenstra-VanderWeele J, Sikich L, Kollins SH, Dawson G. Adaptive Behavior in Young Autistic Children: Associations with Irritability and ADHD Symptoms. J Autism Dev Disord 2022:10.1007/s10803-022-05753-2. [PMID: 36222990 PMCID: PMC10090229 DOI: 10.1007/s10803-022-05753-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 01/14/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40-60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD symptoms or by another associated feature of both autism and ADHD, such as increased irritability. The current study examined relationships between irritability, ADHD symptoms, and adaptive behavior in 3- to 7-year-old autistic children. Results suggest that, after adjusting for co-occurring ADHD symptoms, higher levels of irritability are associated with differences in social adaptive behavior specifically. Understanding relationships between irritability, ADHD, and adaptive behavior in autistic children is critical because measures of adaptive behavior, such as the Vineland Scales of Adaptive Functioning, are often used as a proxy for global functioning, as well as for developing intervention plans and measuring outcomes as primary endpoints in clinical trials.
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Affiliation(s)
- Kimberly L H Carpenter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Naomi O Davis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Marina Spanos
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Rachel Aiello
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Grace T Baranek
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Scott N Compton
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | | | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Soo-Jeong Kim
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Bryan H King
- Department of Psychiatry and Behavioral Sciences, University of California at San Francisco, San Francisco, CA, USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | | | - Kevin Sanders
- Product Development Neuroscience, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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9
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Sridhar A, Kuhn J, Faja S, Sabatos-DeVito M, Nikolaeva JI, Dawson G, Nelson CA, Webb SJ, Bernier R, Jeste S, Chawarska K, Sugar CA, Shic F, Naples A, Dziura J, McPartland JC. Patterns of Intervention Utilization Among School-Aged Children with Autism Spectrum Disorder: Findings from a Multi-Site Research Consortium. Res Autism Spectr Disord 2022; 94. [PMID: 35444715 PMCID: PMC9015686 DOI: 10.1016/j.rasd.2022.101950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
When designing and interpreting results from clinical trials evaluating treatments for children on the autism spectrum, a complicating factor is that most children receive a range of concurrent treatments. Thus, it is important to better understand the types and hours of interventions that participants typically receive as part of standard of care, as well as to understand the child, family, and geographic factors that are associated with different patterns of service utilization. In this multi-site study, we interviewed 280 caregivers of 6-to-11-year-old school-aged children on the autism spectrum about the types and amounts of interventions their children received in the prior 6 weeks. Reported interventions were coded as "evidence-based practice" or "other interventions," reflecting the level of empirical support. Results indicated that children received a variety of interventions with varying levels of empirical evidence and a wide range of hours (0 to 79.3 hours/week). Children with higher autism symptom levels, living in particular states, and who identified as non-Hispanic received more evidence-based intervention hours. Higher parental education level related to more hours of other interventions. Children who were younger, had lower cognitive ability, and with higher autism symptom levels received a greater variety of interventions overall. Thus, based on our findings, it would seem prudent when designing clinical trials to take into consideration a variety of factors including autism symptom levels, age, cognitive ability, ethnicity, parent education and geographic location. Future research should continue to investigate the ethnic, racial, and socioeconomic influences on school-aged intervention services.
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Affiliation(s)
- Aksheya Sridhar
- Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Susan Faja
- Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | | | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - Charles A Nelson
- Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
| | - Sara J Webb
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle WA, USA
| | - Raphael Bernier
- Department of Pediatrics, University of Washington School of Medicine, Seattle WA, USA
| | | | | | | | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle WA, USA
| | | | - James Dziura
- Yale Center for Analytical Sciences, New Haven, CT USA
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10
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Shic F, Naples AJ, Barney EC, Chang SA, Li B, McAllister T, Kim M, Dommer KJ, Hasselmo S, Atyabi A, Wang Q, Helleman G, Levin AR, Seow H, Bernier R, Charwaska K, Dawson G, Dziura J, Faja S, Jeste SS, Johnson SP, Murias M, Nelson CA, Sabatos-DeVito M, Senturk D, Sugar CA, Webb SJ, McPartland JC. The autism biomarkers consortium for clinical trials: evaluation of a battery of candidate eye-tracking biomarkers for use in autism clinical trials. Mol Autism 2022; 13:15. [PMID: 35313957 PMCID: PMC10124777 DOI: 10.1186/s13229-021-00482-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/20/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Eye tracking (ET) is a powerful methodology for studying attentional processes through quantification of eye movements. The precision, usability, and cost-effectiveness of ET render it a promising platform for developing biomarkers for use in clinical trials for autism spectrum disorder (ASD). METHODS The autism biomarkers consortium for clinical trials conducted a multisite, observational study of 6-11-year-old children with ASD (n = 280) and typical development (TD, n = 119). The ET battery included: Activity Monitoring, Social Interactive, Static Social Scenes, Biological Motion Preference, and Pupillary Light Reflex tasks. A priori, gaze to faces in Activity Monitoring, Social Interactive, and Static Social Scenes tasks were aggregated into an Oculomotor Index of Gaze to Human Faces (OMI) as the primary outcome measure. This work reports on fundamental biomarker properties (data acquisition rates, construct validity, six-week stability, group discrimination, and clinical relationships) derived from these assays that serve as a base for subsequent development of clinical trial biomarker applications. RESULTS All tasks exhibited excellent acquisition rates, met expectations for construct validity, had moderate or high six-week stabilities, and highlighted subsets of the ASD group with distinct biomarker performance. Within ASD, higher OMI was associated with increased memory for faces, decreased autism symptom severity, and higher verbal IQ and pragmatic communication skills. LIMITATIONS No specific interventions were administered in this study, limiting information about how ET biomarkers track or predict outcomes in response to treatment. This study did not consider co-occurrence of psychiatric conditions nor specificity in comparison with non-ASD special populations, therefore limiting our understanding of the applicability of outcomes to specific clinical contexts-of-use. Research-grade protocols and equipment were used; further studies are needed to explore deployment in less standardized contexts. CONCLUSIONS All ET tasks met expectations regarding biomarker properties, with strongest performance for tasks associated with attention to human faces and weakest performance associated with biological motion preference. Based on these data, the OMI has been accepted to the FDA's Biomarker Qualification program, providing a path for advancing efforts to develop biomarkers for use in clinical trials.
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Affiliation(s)
- Frederick Shic
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA.
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
| | - Adam J Naples
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Erin C Barney
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Shou An Chang
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, 06520, USA
| | - Beibin Li
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA
| | - Takumi McAllister
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Minah Kim
- Department of Psychology, University of Virginia, 102 Gilmer Hall, P.O. Box 400400, Charlottesville, VA, 22904, USA
| | - Kelsey J Dommer
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
| | - Simone Hasselmo
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Adham Atyabi
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- Department of Computer Science, University of Colorado - Colorado Springs, Colorado Springs, CO, USA
| | - Quan Wang
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Gerhard Helleman
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - April R Levin
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Helen Seow
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Raphael Bernier
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
| | - Katarzyna Charwaska
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - James Dziura
- Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Susan Faja
- Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Shafali Spurling Jeste
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Scott P Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael Murias
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Charles A Nelson
- Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Graduate School of Education, Harvard University, Boston, MA, USA
| | | | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine A Sugar
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Sara J Webb
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
| | - James C McPartland
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA.
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11
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Webb SJ, Emerman I, Sugar C, Senturk D, Naples AJ, Faja S, Benton J, Borland H, Carlos C, Levin AR, McAllister T, Santhosh M, Bernier RA, Chawarska K, Dawson G, Dziura J, Jeste S, Kleinhans N, Murias M, Sabatos-DeVito M, Shic F, McPartland JC. Identifying Age Based Maturation in the ERP Response to Faces in Children With Autism: Implications for Developing Biomarkers for Use in Clinical Trials. Front Psychiatry 2022; 13:841236. [PMID: 35615454 PMCID: PMC9126041 DOI: 10.3389/fpsyt.2022.841236] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/21/2022] [Indexed: 01/27/2023] Open
Abstract
Recent proposals have suggested the potential for neural biomarkers to improve clinical trial processes in neurodevelopmental conditions; however, few efforts have identified whether chronological age-based adjustments will be necessary (as used in standardized behavioral assessments). Event-related potentials (ERPs) demonstrate early differences in the processing of faces vs. objects in the visual processing system by 4 years of age and age-based improvement (decreases in latency) through adolescence. Additionally, face processing has been proposed to be related to social skills as well as autistic social-communication traits. While previous reports suggest delayed latency in individuals with autism spectrum disorder (ASD), extensive individual and age based heterogeneity exists. In this report, we utilize a sample of 252 children with ASD and 118 children with typical development (TD), to assess the N170 and P100 ERP component latencies (N170L and P100L, respectively), to upright faces, the face specificity effect (difference between face and object processing), and the inversion effect (difference between face upright and inverted processing) in relation to age. First, linear mixed models (LMMs) were fitted with fixed effect of age at testing and random effect of participant, using all available data points to characterize general age-based development in the TD and ASD groups. Second, LMM models using only the TD group were used to calculate age-based residuals in both groups. The purpose of residualization was to assess how much variation in ASD participants could be accounted for by chronological age-related changes. Our data demonstrate that the N170L and P100L responses to upright faces appeared to follow a roughly linear relationship with age. In the ASD group, the distribution of the age-adjusted residual values suggest that ASD participants were more likely to demonstrate slower latencies than would be expected for a TD child of the same age, similar to what has been identified using unadjusted values. Lastly, using age-adjusted values for stratification, we found that children who demonstrated slowed age-adjusted N170L had lower verbal and non-verbal IQ and worse face memory. These data suggest that age must be considered in assessing the N170L and P100L response to upright faces as well, and these adjusted values may be used to stratify children within the autism spectrum.
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Affiliation(s)
- Sara Jane Webb
- Center on Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Iris Emerman
- Center on Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Catherine Sugar
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Statistics, University of California, Los Angeles, Los Angeles, CA, United States
| | - Damla Senturk
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Statistics, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adam J Naples
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - Susan Faja
- Harvard Medical School, Harvard University, Boston, MA, United States.,Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Jessica Benton
- Center on Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Heather Borland
- Center on Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Carter Carlos
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - April R Levin
- Harvard Medical School, Harvard University, Boston, MA, United States.,Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Takumi McAllister
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - Megha Santhosh
- Center on Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Raphael A Bernier
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | | | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States.,Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, United States
| | - James Dziura
- Yale Center for Clinical Investigation, Yale University, New Haven, CT, United States
| | - Shafali Jeste
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Neurology, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Natalia Kleinhans
- Center on Human Development and Disabilities, University of Washington, Seattle, WA, United States.,Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States
| | - Michael Murias
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States.,Medical Social Sciences, Northwestern University, Chicago, IL, United States
| | - Maura Sabatos-DeVito
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, United States
| | - Frederick Shic
- Center on Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, WA, United States.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
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12
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Franz L, Howard J, Viljoen M, Sikich L, Chandrasekhar T, Kollins SH, Lee L, Ndlovu M, Sabatos-DeVito M, Seris N, Shabalala N, Spanos M, de Vries PJ, Dawson G. Pragmatic adaptations of telehealth-delivered caregiver coaching for children with autism in the context of COVID-19: Perspectives from the United States and South Africa. Autism 2022; 26:270-275. [PMID: 34098745 PMCID: PMC8651809 DOI: 10.1177/13623613211022585] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
LAY ABSTRACT COVID-19 caused many autism spectrum disorder caregiver-coaching studies to move to telehealth. Telehealth can increase the diversity of people who take part in research. This matters because most autism spectrum disorder studies have included people who have resources, are White, and live in North America and Europe. When study participants are similar, it is hard to understand which interventions can help different types of people who live in different parts of the world. While telehealth may allow more people to take part in research, it needs to "fit" the local context and consider the "digital divide" because many people around the world have no access to computers and the Internet. This short report describes changes to two research studies that include caregiver coaching based on the Early Start Denver Model in the United States and South Africa. We describe how the local context, including technology and Internet access, guided the telehealth approach. By doing so, we highlight ways to make telehealth available to more people around the world. The pandemic can help us understand how telehealth can "fit" diverse places and support high-quality research. It is important that study changes are tracked and we assess how well the changes work. COVID-19 telehealth changes to caregiver coaching can result in new ways to reach more people around the world.
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Affiliation(s)
- Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, South Africa
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
| | - Marisa Viljoen
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, South Africa
| | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
| | - Tara Chandrasekhar
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Lawrence Lee
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
| | - Minkateko Ndlovu
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, South Africa
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
| | - Noleen Seris
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, South Africa
| | - Nokuthula Shabalala
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, South Africa
| | - Marina Spanos
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
| | - Petrus J de Vries
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, South Africa
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke Center for Autism and Brain Development, Durham, NC, USA
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13
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Tenenbaum EJ, Carpenter KLH, Sabatos-DeVito M, Hashemi J, Vermeer S, Sapiro G, Dawson G. A Six-Minute Measure of Vocalizations in Toddlers with Autism Spectrum Disorder. Autism Res 2020; 13:1373-1382. [PMID: 32212384 PMCID: PMC7881362 DOI: 10.1002/aur.2293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/10/2019] [Revised: 09/24/2019] [Accepted: 03/03/2020] [Indexed: 01/08/2023]
Abstract
To improve early identification of autism spectrum disorder (ASD), we need objective, reliable, and accessible measures. To that end, a previous study demonstrated that a tablet-based application (app) that assessed several autism risk behaviors distinguished between toddlers with ASD and non-ASD toddlers. Using vocal data collected during this study, we investigated whether vocalizations uttered during administration of this app can distinguish among toddlers aged 16-31 months with typical development (TD), language or developmental delay (DLD), and ASD. Participant's visual and vocal responses were recorded using the camera and microphone in a tablet while toddlers watched movies designed to elicit behaviors associated with risk for ASD. Vocalizations were then coded offline. Results showed that (a) children with ASD and DLD were less likely to produce words during app administration than TD participants; (b) the ratio of syllabic vocalizations to all vocalizations was higher among TD than ASD or DLD participants; and (c) the rates of nonsyllabic vocalizations were higher in the ASD group than in either the TD or DLD groups. Those producing more nonsyllabic vocalizations were 24 times more likely to be diagnosed with ASD. These results lend support to previous findings that early vocalizations might be useful in identifying risk for ASD in toddlers and demonstrate the feasibility of using a scalable tablet-based app for assessing vocalizations in the context of a routine pediatric visit. LAY SUMMARY: Although parents often report symptoms of autism spectrum disorder (ASD) in infancy, we are not yet reliably diagnosing ASD until much later in development. A previous study tested a tablet-based application (app) that recorded behaviors we know are associated with ASD to help identify children at risk for the disorder. Here we measured how children vocalize while they watched the movies presented on the tablet. Children with ASD were less likely to produce words, less likely to produce speechlike sounds, and more likely to produce atypical sounds while watching these movies. These measures, combined with other behaviors measured by the app, might help identify which children should be evaluated for ASD. Autism Res 2020, 13: 1373-1382. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Elena J Tenenbaum
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Kimberly L H Carpenter
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Jordan Hashemi
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Electrical and Computer Engineering, Duke University, Durham, North Carolina, USA
| | - Saritha Vermeer
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Guillermo Sapiro
- Electrical and Computer Engineering, Duke University, Durham, North Carolina, USA
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
- Department of Computer Science, Duke University, Durham, North Carolina, USA
- Department of Mathematics, Duke University, Durham, North Carolina, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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14
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Dawson G, Sun JM, Baker J, Carpenter K, Compton S, Deaver M, Franz L, Heilbron N, Herold B, Horrigan J, Howard J, Kosinski A, Major S, Murias M, Page K, Prasad VK, Sabatos-DeVito M, Sanfilippo F, Sikich L, Simmons R, Song A, Vermeer S, Waters-Pick B, Troy J, Kurtzberg J. A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder. J Pediatr 2020; 222:164-173.e5. [PMID: 32444220 DOI: 10.1016/j.jpeds.2020.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate whether umbilical cord blood (CB) infusion is safe and associated with improved social and communication abilities in children with autism spectrum disorder (ASD). STUDY DESIGN This prospective, randomized, placebo-controlled, double-blind study included 180 children with ASD, aged 2-7 years, who received a single intravenous autologous (n = 56) or allogeneic (n = 63) CB infusion vs placebo (n = 61) and were evaluated at 6 months postinfusion. RESULTS CB infusion was safe and well tolerated. Analysis of the entire sample showed no evidence that CB was associated with improvements in the primary outcome, social communication (Vineland Adaptive Behavior Scales-3 [VABS-3] Socialization Domain), or the secondary outcomes, autism symptoms (Pervasive Developmental Disorder Behavior Inventory) and vocabulary (Expressive One-Word Picture Vocabulary Test). There was also no overall evidence of differential effects by type of CB infused. In a subanalysis of children without intellectual disability (ID), allogeneic, but not autologous, CB was associated with improvement in a larger percentage of children on the clinician-rated Clinical Global Impression-Improvement scale, but the OR for improvement was not significant. Children without ID treated with CB showed significant improvements in communication skills (VABS-3 Communication Domain), and exploratory measures including attention to toys and sustained attention (eye-tracking) and increased alpha and beta electroencephalographic power. CONCLUSIONS Overall, a single infusion of CB was not associated with improved socialization skills or reduced autism symptoms. More research is warranted to determine whether CB infusion is an effective treatment for some children with ASD.
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Affiliation(s)
- Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC; Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC.
| | - Jessica M Sun
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Jennifer Baker
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Kimberly Carpenter
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Scott Compton
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Megan Deaver
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Nicole Heilbron
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Brianna Herold
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Joseph Horrigan
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Andrzej Kosinski
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Samantha Major
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Michael Murias
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Kristin Page
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Vinod K Prasad
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | | | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Ryan Simmons
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Allen Song
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC; Duke Brain Imaging and Analysis Center, Duke University School of Medicine, Durham, NC
| | - Saritha Vermeer
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Barbara Waters-Pick
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Jesse Troy
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Joanne Kurtzberg
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
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15
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McPartland JC, Bernier RA, Jeste SS, Dawson G, Nelson CA, Chawarska K, Earl R, Faja S, Johnson SP, Sikich L, Brandt CA, Dziura JD, Rozenblit L, Hellemann G, Levin AR, Murias M, Naples AJ, Platt ML, Sabatos-DeVito M, Shic F, Senturk D, Sugar CA, Webb SJ. The Autism Biomarkers Consortium for Clinical Trials (ABC-CT): Scientific Context, Study Design, and Progress Toward Biomarker Qualification. Front Integr Neurosci 2020; 14:16. [PMID: 32346363 PMCID: PMC7173348 DOI: 10.3389/fnint.2020.00016] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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: 11/22/2019] [Accepted: 03/10/2020] [Indexed: 12/19/2022] Open
Abstract
Clinical research in neurodevelopmental disorders remains reliant upon clinician and caregiver measures. Limitations of these approaches indicate a need for objective, quantitative, and reliable biomarkers to advance clinical research. Extant research suggests the potential utility of multiple candidate biomarkers; however, effective application of these markers in trials requires additional understanding of replicability, individual differences, and intra-individual stability over time. The Autism Biomarkers Consortium for Clinical Trials (ABC-CT) is a multi-site study designed to investigate a battery of electrophysiological (EEG) and eye-tracking (ET) indices as candidate biomarkers for autism spectrum disorder (ASD). The study complements published biomarker research through: inclusion of large, deeply phenotyped cohorts of children with ASD and typical development; a longitudinal design; a focus on well-evidenced candidate biomarkers harmonized with an independent sample; high levels of clinical, regulatory, technical, and statistical rigor; adoption of a governance structure incorporating diverse expertise in the ASD biomarker discovery and qualification process; prioritization of open science, including creation of a repository containing biomarker, clinical, and genetic data; and use of economical and scalable technologies that are applicable in developmental populations and those with special needs. The ABC-CT approach has yielded encouraging results, with one measure accepted into the FDA’s Biomarker Qualification Program to date. Through these advances, the ABC-CT and other biomarker studies in progress hold promise to deliver novel tools to improve clinical trials research in ASD.
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Affiliation(s)
| | - Raphael A Bernier
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Shafali S Jeste
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Charles A Nelson
- Boston Children's Hospital and Harvard Medical School, Boston, MA, United States.,Harvard University, Boston, MA, United States
| | | | - Rachel Earl
- Center on Human Development and Disability, University of Washington, Seattle, WA, United States
| | - Susan Faja
- Boston Children's Hospital and Harvard Medical School, Boston, MA, United States.,Harvard University, Boston, MA, United States
| | - Scott P Johnson
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Linmarie Sikich
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | | | | | | | - Gerhard Hellemann
- University of California, Los Angeles, Los Angeles, CA, United States
| | - April R Levin
- Boston Children's Hospital and Harvard Medical School, Boston, MA, United States.,Harvard University, Boston, MA, United States
| | | | - Adam J Naples
- Yale Child Study Center, New Haven, CT, United States
| | | | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, WA, United States.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
| | - Damla Senturk
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Catherine A Sugar
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Sara J Webb
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
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16
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Webb SJ, Shic F, Murias M, Sugar CA, Naples AJ, Barney E, Borland H, Hellemann G, Johnson S, Kim M, Levin AR, Sabatos-DeVito M, Santhosh M, Senturk D, Dziura J, Bernier RA, Chawarska K, Dawson G, Faja S, Jeste S, McPartland J. Biomarker Acquisition and Quality Control for Multi-Site Studies: The Autism Biomarkers Consortium for Clinical Trials. Front Integr Neurosci 2020; 13:71. [PMID: 32116579 PMCID: PMC7020808 DOI: 10.3389/fnint.2019.00071] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 04/02/2019] [Accepted: 11/28/2019] [Indexed: 12/31/2022] Open
Abstract
The objective of the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) is to evaluate a set of lab-based behavioral video tracking (VT), electroencephalography (EEG), and eye tracking (ET) measures for use in clinical trials with children with autism spectrum disorder (ASD). Within the larger organizational structure of the ABC-CT, the Data Acquisition and Analytic Core (DAAC) oversees the standardization of VT, EEG, and ET data acquisition, data processing, and data analysis. This includes designing and documenting data acquisition and analytic protocols and manuals; facilitating site training in acquisition; data acquisition quality control (QC); derivation and validation of dependent variables (DVs); and analytic deliverables including preparation of data for submission to the National Database for Autism Research (NDAR). To oversee consistent application of scientific standards and methodological rigor for data acquisition, processing, and analytics, we developed standard operating procedures that reflect the logistical needs of multi-site research, and the need for well-articulated, transparent processes that can be implemented in future clinical trials. This report details the methodology of the ABC-CT related to acquisition and QC in our Feasibility and Main Study phases. Based on our acquisition metrics from a preplanned interim analysis, we report high levels of acquisition success utilizing VT, EEG, and ET experiments in a relatively large sample of children with ASD and typical development (TD), with data acquired across multiple sites and use of a manualized training and acquisition protocol.
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Affiliation(s)
- Sara Jane Webb
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Frederick Shic
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
| | - Michael Murias
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Catherine A. Sugar
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Statistics, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adam J. Naples
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - Erin Barney
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Heather Borland
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Scott Johnson
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Minah Kim
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - April R. Levin
- Department of Neurology, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Megha Santhosh
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Damla Senturk
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Statistics, University of California, Los Angeles, Los Angeles, CA, United States
| | - James Dziura
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - Raphael A. Bernier
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
- Center on Human Development and Disability, University of Washington, Seattle, WA, United States
| | | | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Susan Faja
- Harvard Medical School, Harvard University, Boston, MA, United States
- Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
| | - Shafali Jeste
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
| | - James McPartland
- Yale Child Study Center, Yale University, New Haven, CT, United States
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17
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Sabatos-DeVito M, Murias M, Dawson G, Howell T, Yuan A, Marsan S, Bernier RA, Brandt CA, Chawarska K, Dzuira JD, Faja S, Jeste SS, Naples A, Nelson CA, Shic F, Sugar CA, Webb SJ, McPartland JC. Methodological considerations in the use of Noldus EthoVision XT video tracking of children with autism in multi-site studies. Biol Psychol 2019; 146:107712. [PMID: 31163191 PMCID: PMC7334026 DOI: 10.1016/j.biopsycho.2019.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 04/02/2019] [Accepted: 05/31/2019] [Indexed: 11/19/2022]
Abstract
Animal models of autism spectrum disorders (ASD) contribute to understanding of the role of genetics and the biological mechanisms underlying behavioral phenotypes and inform the development of potential treatments. Translational biomarkers are needed that can both validate these models and facilitate behavioral testing paradigms for ASD in humans. Automated video tracking of movement patterns and positions recorded from overhead cameras is routinely applied in behavioral paradigms designed to elicit core behavioral manifestations of ASD in rodent models. In humans, laboratory-based observations are a common semi-naturalistic context for assessing a variety of behaviors relevant to ASD such as social engagement, play, and attention. We present information learned and suggest guidelines for designing, recording, acquiring, and evaluating video tracking data of human movement patterns based on our experience in a multi-site video tracking study of children with ASD in the context of a parent-child, laboratory-based play interaction.
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Affiliation(s)
- Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, NC, USA.
| | - Michael Murias
- Duke Institute for Brain Sciences, Duke University Medical Center, Durham, NC, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, NC, USA
| | - Toni Howell
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, NC, USA
| | - Andrew Yuan
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, NC, USA
| | - Samuel Marsan
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, NC, USA
| | - Raphael A Bernier
- Department of Psychiatry, University of Washington, Seattle, WA, USA
| | | | | | - James D Dzuira
- Department of Emergency Medicine, Yale Center for Analytical Sciences, Yale University, CT, USA
| | - Susan Faja
- Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Shafali S Jeste
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Adam Naples
- Yale University School of Medicine, Child Study Center, New Haven, CT, USA
| | - Charles A Nelson
- Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Harvard Graduate School of Education, Boston, MA, USA
| | - Frederick Shic
- University of Washington and Seattle Children's Research Institute Center for Child Behavior, Health, and Development, Seattle, WA, USA
| | - Catherine A Sugar
- Departments of Biostatistics, Statistics and Psychiatry, University of California, Los Angeles, CA, USA
| | - Sara J Webb
- University of Washington and Seattle Children's Research Institute Center for Child Behavior, Health, and Development, Seattle, WA, USA
| | - James C McPartland
- Yale University School of Medicine, Child Study Center, New Haven, CT, USA.
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18
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Murias M, Major S, Davlantis K, Franz L, Harris A, Rardin B, Sabatos-DeVito M, Dawson G. Validation of eye-tracking measures of social attention as a potential biomarker for autism clinical trials. Autism Res 2017; 11:166-174. [PMID: 29193826 DOI: 10.1002/aur.1894] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [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: 02/21/2017] [Revised: 09/28/2017] [Accepted: 11/06/2017] [Indexed: 12/17/2022]
Abstract
Social communication impairments are a core feature of autism spectrum disorder (ASD), and this class of symptoms is a target for treatments for the disorder. Measures of social attention, assessed via eye-gaze tracking (EGT), have been proposed as an early efficacy biomarker for clinical trials targeting social communication skills. EGT measures have been shown to differentiate children with ASD from typical children; however, there is less known about their relationships with social communication outcome measures that are typically used in ASD clinical trials. In the present study, an EGT task involving viewing a videotape of an actor making bids for a child's attention was evaluated in 25 children with ASD aged 24-72 months. Children's attention to the actor during the dyadic bid condition measured via EGT was found to be strongly associated with five well-validated caregiver-reported outcome measures that are commonly used to assess social communication in clinical trials. These results highlight the convergent validity of EGT measures of social attention in relation to caregiver-reported clinical measures. EGT holds promise as a non-invasive, quantitative, and objective biomarker that is associated with social communication abilities in children with ASD. Autism Res 2018, 11: 166-174. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Eye-gaze tracking (EGT), an automated tool that tracks eye-gaze patterns, might help measure outcomes in clinical trials investigating interventions to treat autism spectrum disorders. In this study, an EGT task was evaluated in children with ASD, who watched a video with an actor talking directly to them. Patterns of eye-gaze were associated with caregiver-reported measures of social communication that are used in clinical trials. We show EGT may be a promising objective tool measuring outcomes.
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Affiliation(s)
- Michael Murias
- Duke Institute for Brain Sciences, 308 Research Drive, Duke University, Durham, NC, 27710.,Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC
| | - Samantha Major
- Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701
| | - Katherine Davlantis
- Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701
| | - Lauren Franz
- Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701
| | - Adrianne Harris
- Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC
| | - Benjamin Rardin
- Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701
| | - Geraldine Dawson
- Duke Institute for Brain Sciences, 308 Research Drive, Duke University, Durham, NC, 27710.,Duke Center for Autism and Brain Development, 2608 Erwin Road, Suite 300, Duke University, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701
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19
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Dawson G, Sun JM, Davlantis KS, Murias M, Franz L, Troy J, Simmons R, Sabatos-DeVito M, Durham R, Kurtzberg J. Autologous Cord Blood Infusions Are Safe and Feasible in Young Children with Autism Spectrum Disorder: Results of a Single-Center Phase I Open-Label Trial. Stem Cells Transl Med 2017; 6:1332-1339. [PMID: 28378499 PMCID: PMC5442708 DOI: 10.1002/sctm.16-0474] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/16/2017] [Indexed: 01/19/2023] Open
Abstract
Despite advances in early diagnosis and behavioral therapies, more effective treatments for children with autism spectrum disorder (ASD) are needed. We hypothesized that umbilical cord blood‐derived cell therapies may have potential in alleviating ASD symptoms by modulating inflammatory processes in the brain. Accordingly, we conducted a phase I, open‐label trial to assess the safety and feasibility of a single intravenous infusion of autologous umbilical cord blood, as well as sensitivity to change in several ASD assessment tools, to determine suitable endpoints for future trials. Twenty‐five children, median age 4.6 years (range 2.26–5.97), with a confirmed diagnosis of ASD and a qualified banked autologous umbilical cord blood unit, were enrolled. Children were evaluated with a battery of behavioral and functional tests immediately prior to cord blood infusion (baseline) and 6 and 12 months later. Assessment of adverse events across the 12‐month period indicated that the treatment was safe and well tolerated. Significant improvements in children's behavior were observed on parent‐report measures of social communication skills and autism symptoms, clinician ratings of overall autism symptom severity and degree of improvement, standardized measures of expressive vocabulary, and objective eye‐tracking measures of children's attention to social stimuli, indicating that these measures may be useful endpoints in future studies. Behavioral improvements were observed during the first 6 months after infusion and were greater in children with higher baseline nonverbal intelligence quotients. These data will serve as the basis for future studies to determine the efficacy of umbilical cord blood infusions in children with ASD. Stem Cells Translational Medicine2017;6:1332–1339
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Affiliation(s)
- Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University Medical Center
| | - Jessica M Sun
- Robertson Clinical and Translational Cell Therapy Program, Duke University Medical Center
| | | | - Michael Murias
- Duke Center for Autism and Brain Development, Duke University Medical Center.,Duke Institute for Brain Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Lauren Franz
- Duke Center for Autism and Brain Development, Duke University Medical Center
| | - Jesse Troy
- Robertson Clinical and Translational Cell Therapy Program, Duke University Medical Center
| | - Ryan Simmons
- Robertson Clinical and Translational Cell Therapy Program, Duke University Medical Center
| | | | - Rebecca Durham
- Robertson Clinical and Translational Cell Therapy Program, Duke University Medical Center
| | - Joanne Kurtzberg
- Robertson Clinical and Translational Cell Therapy Program, Duke University Medical Center
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20
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Stephens RL, Sabatos-DeVito M, Reznick JS. The development and validation of attention constructs from the First Year Inventory. Psychol Assess 2016; 29:568-581. [PMID: 27504901 DOI: 10.1037/pas0000380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Individual differences in early attention are associated with later social, cognitive, and emotional development, and attentional deficits in the first year are associated with risk for developmental disorders such as Autism Spectrum Disorder (ASD). The First Year Inventory (FYI; Baranek, Watson, Crais, & Reznick, 2003) was developed to identify 12-month-olds at risk for an ASD diagnosis. The current study identifies FYI items that reflect aspects of early attention that might predict future typical and atypical social, cognitive, and emotional development. Using a series of theoretical and statistical methods, we developed 3 attention-based constructs from the FYI: Responding to Social Attention (RSA), Initiating Social Attention (ISA), and Nonsocial Sensory Attention (NSA). A database with completed FYIs was analyzed using these constructs to determine the strength of relations among items. Cronbach's alpha analyses indicated good internal consistency, and item distribution was further supported using a confirmatory factor analysis. Data analyses showed statistically significant relations between the scores on these domains at 12 months and subsequent social responsiveness scores at 3 years. Analyses demonstrating the statistical and predictive validity of these 3 FYI attention constructs support their use for innovative explorations of infant behavioral patterns that can be used to predict typical and atypical individual trajectories in the development of later social, cognitive, and emotional skills. (PsycINFO Database Record
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Affiliation(s)
- Rebecca L Stephens
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Maura Sabatos-DeVito
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - J Steven Reznick
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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