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Shuster CL, Brennan PA, Carter BS, Check J, D'Sa V, Graff JC, Helderman J, Hofheimer JA, Joseph RM, Murphy LE, O'Connor TG, O'Shea TM, Pievsky M, Sheinkopf SJ, Shuffrey LC, Smith LM, Wu PC, Lester BM. Developmental characteristics and accuracy of autism screening among two-year-old toddlers in the ECHO program. Pediatr Res 2024:10.1038/s41390-024-03193-5. [PMID: 38622260 DOI: 10.1038/s41390-024-03193-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The Modified Checklist for Autism in Toddlers (M-CHAT) is a common pediatric screening tool with mixed accuracy findings. Prior evidence supports M-CHAT screening for developmental concerns, especially in toddlers born preterm. This study examined M-CHAT accuracy in a large, nationwide sample. METHODS 3393 participants from the Environmental influences on Child Health Outcomes (ECHO) program were included. Harmonized M-CHAT (M-CHAT-H) results were compared with parent-reported autism diagnosis and autism-related characteristics to assess accuracy for term and preterm children, together and separately. Generalized estimating equations, clustering for ECHO cohort and controlling for demographic covariates, were used to examine associations between developmental and behavioral characteristics with M-CHAT-H accuracy. RESULTS Sensitivity of the M-CHAT-H ranged from 36 to 60%; specificity ranged from 88 to 99%. Positive M-CHAT-H was associated with more developmental delays and behavior problems. Children with severe motor delays and more autism-related problems were more likely to have a false-negative M-CHAT-H. Children with fewer behavior problems and fewer autism-related concerns were more likely to have a false-positive screen. CONCLUSION The M-CHAT-H accurately detects children at low risk for autism and children at increased risk with moderate accuracy. These findings support use of the M-CHAT-H in assessing autism risk and developmental and behavioral concerns in children. IMPACT Previous literature regarding accuracy of the Modified Checklist for Autism in Toddlers (M-CHAT) is mixed but this study provides evidence that the M-CHAT performs well in detecting children at low risk for autism and consistently detects children with developmental delays and behavioral problems. The M-CHAT moderately detects children at increased risk for autism and remains a useful screening tool. This study examines M-CHAT accuracy in a large-scale, nationwide sample, examining associations between screening accuracy and developmental outcomes. These findings impact pediatric screening for autism, supporting continued use of the M-CHAT while further elucidating the factors associated with inaccurate screens.
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Affiliation(s)
- Coral L Shuster
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA.
| | - Patricia A Brennan
- Department of Psychology, Emory University School of Medicine, Atlanta, GA, USA
| | - Brian S Carter
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jennifer Check
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Viren D'Sa
- Division of Developmental and Behavioral Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
| | - Joyce C Graff
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jennifer Helderman
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Julie A Hofheimer
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert M Joseph
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Laura E Murphy
- Department of Psychiatry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - T Michael O'Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michelle Pievsky
- Department of Psychiatry and Human Behavior, Hasbro Children's Hospital, Lifespan, Providence, RI, USA
| | - Stephen J Sheinkopf
- Thompson Center for Autism & Neurodevelopment, University of Missouri, Columbia, MO, USA
| | - Lauren C Shuffrey
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Lynne M Smith
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Pei-Chi Wu
- Developmental Behavioral Pediatrics, Children's Neurodevelopment Center, Lifespan, Providence, RI, USA
| | - Barry M Lester
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA
- Department of Pediatrics, Brown Alpert Medical School, Providence, RI, USA
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2
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Shuster CL, Sheinkopf SJ, McGowan EC, Hofheimer JA, O’Shea TM, Carter BS, Helderman JB, Check J, Neal CR, Pastyrnak SL, Smith LM, Loncar C, Dansereau LM, DellaGrotta SA, Marsit CJ, Lester BM. Two-Year Autism Risk Screening and 3-Year Developmental Outcomes in Very Preterm Infants. JAMA Pediatr 2024; 178:168-175. [PMID: 38147347 PMCID: PMC10751654 DOI: 10.1001/jamapediatrics.2023.5727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/25/2023] [Indexed: 12/27/2023]
Abstract
Importance Use of the Modified Checklist for Autism in Toddlers, Revised With Follow-Up, a 2-stage parent-report autism risk screening tool, has been questioned due to reports of poor sensitivity and specificity. How this measure captures developmental delays for very preterm infants may provide support for continued use in pediatric care settings. Objective To determine whether autism risk screening with the 2-stage parent-report autism risk screening tool at age 2 years is associated with behavioral and developmental outcomes at age 3 in very preterm infants. Design, Setting, and Participants Neonatal Neurobehavior and Outcomes for Very Preterm Infants was a longitudinal, multisite cohort study. Enrollment occurred April 2014 to June 2016, and analyses were conducted from November 2022 to May 2023. Data were collected across 9 university-affiliated neonatal intensive care units (NICUs). Inclusion criteria were infants born less than 30 weeks' gestational age, a parent who could read and speak English and/or Spanish, and residence within 3 hours of the NICU and follow-up clinic. Exposures Prematurity and use of the 2-stage parent-report autism risk screening tool at age 2 years. Main Outcomes and Measures Outcomes include cognitive, language, motor composites on Bayley Scales for Infant and Toddler Development, third edition (Bayley-III) and internalizing, externalizing, total problems, and pervasive developmental disorder (PDD) subscale on the Child Behavior Checklist (CBCL) at age 3 years. Generalized estimating equations tested associations between the 2-stage parent-report autism risk screening tool and outcomes, adjusting for covariates. Results A total of 467 children (mean [SD] gestational age, 27.1 [1.8] weeks; 243 male [52%]) were screened with the 2-stage parent-report autism risk screening tool at age 2 years, and outcome data at age 3 years were included in analyses. Mean (SD) maternal age at birth was 29 (6) years. A total of 51 children (10.9%) screened positive on the 2-stage parent-report autism risk screening tool at age 2 years. Children with positive screening results were more likely to have Bayley-III composites of 84 or less on cognitive (adjusted odds ratio [aOR], 4.03; 95% CI, 1.65-9.81), language (aOR, 5.38; 95% CI, 2.43-11.93), and motor (aOR, 4.74; 95% CI, 2.19-10.25) composites and more likely to have CBCL scores of 64 or higher on internalizing (aOR, 4.83; 95% CI, 1.88-12.44), externalizing (aOR, 2.69; 95% CI, 1.09-6.61), and PDD (aOR, 3.77; 95% CI, 1.72-8.28) scales. Conclusions and Relevance Results suggest that the 2-stage parent-report autism risk screening tool administered at age 2 years was a meaningful screen for developmental delays in very preterm infants, with serious delays detected at age 3 years.
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Affiliation(s)
- Coral L. Shuster
- The Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, Rhode Island
| | - Stephen J. Sheinkopf
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia
| | - Elisabeth C. McGowan
- The Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, Rhode Island
- Brown Alpert Medical School, Providence, Rhode Island
| | | | | | | | | | - Jennifer Check
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Charles R. Neal
- University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
| | | | | | | | - Lynne M. Dansereau
- The Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, Rhode Island
| | - Sheri A. DellaGrotta
- The Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, Rhode Island
| | | | - Barry M. Lester
- The Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, Rhode Island
- Brown Alpert Medical School, Providence, Rhode Island
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Clarke EB, McCauley JB, Lutz A, Gotelli M, Sheinkopf SJ, Lord C. Understanding profound autism: implications for stigma and supports. Front Psychiatry 2024; 15:1287096. [PMID: 38317766 PMCID: PMC10839016 DOI: 10.3389/fpsyt.2024.1287096] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Societal perceptions and lack of understanding of autism spectrum disorder can be stigmatizing for autistic individuals and their families. This may be particularly the case for individuals who meet criteria for profound autism. Despite the considerable service needs of this marginalized group, there is little data on the prevalence of profound autism, nor on the experiences of those with profound autism and their families. Methods The current study leveraged a mixed-methods approach to address these gaps. First, the prevalence of profound autism was examined in six samples-three from the United States and three from Western Europe. Second, inductive thematic analysis was used to code interviews from 20 caregivers of profoundly autistic adults. Results The prevalence of profound autism varied widely across the six samples-from 11% to 48%. There were also notable differences between samples in prevalence by gender, race, and ethnicity. Two overarching themes were identified via inductive thematic analysis: Community Perceptions of Autism and Family Support Needs and Advocacy Challenges. Though caregivers were not directly asked about stigmatization during interviews, 85% of caregivers reported at least one instance of perceived stigma. Discussion Future research should continue to examine the unique needs and stigmatization experiences of profoundly autistic individuals and their families across the life course.
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Affiliation(s)
- Elaine B. Clarke
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - James B. McCauley
- Department of Psychology, St. Mary’s College of California, Moraga, CA, United States
| | - Amy Lutz
- Department of History and Sociology of Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Marina Gotelli
- Fundación Brincar por un Autismo Feliz, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas Y Técnicas, Buenos Aires, Argentina
| | - Stephen J. Sheinkopf
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO, United States
| | - Catherine Lord
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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Radoeva PD, Milev VT, Hunt JI, Legere CH, Deoni SCL, Sheinkopf SJ, Mazefsky CA, Philip NS, Dickstein DP. Systematic Review: White Matter Microstructural Organization in Adolescents With Depression. JAACAP Open 2023; 1:233-245. [PMID: 38576601 PMCID: PMC10994197 DOI: 10.1016/j.jaacop.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Objective A growing body of literature has focused on the neural mechanisms of depression. Our goal was to conduct a systematic review on the white matter microstructural differences in adolescents with depressive disorders vs adolescents without depressive disorders. Method We searched PubMed and PsycINFO for publications on August 3, 2022 (original search conducted in July 2021). The review was registered on PROSPERO (registration number: CRD42021268200), and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Eligible studies were original research papers comparing diffusion tensor/spectrum imaging findings in adolescents with vs without depression (originally ages 12-19 years, later expanded to 11-21 years). Studies were excluded if they focused on depression exclusively in the context of another condition, used only dimensional depressive symptom assessment(s), or used the same dataset as another included publication. Results The search yielded 575 unique records, of which 14 full-text papers were included (824 adolescents with depression and 686 without depression). The following white matter regions showed significant differences in fractional anisotropy in at least 3 studies: uncinate fasciculus, cingulum, anterior corona radiata, inferior fronto-occipital fasciculus, and corpus callosum (genu and body). Most studies reported decreased, rather than increased, fractional anisotropy in adolescents with depression. Limitations include the possibility for selective reporting bias and risk of imprecision, given the small sample sizes in some studies. Conclusion Our systematic review suggests aberrant white matter microstructure in limbic-cortical-striatal-thalamic circuits, and the corpus callosum, in adolescents with depression. Future research should focus on developmental trajectories in depression, identifying sources of heterogeneity and integrating findings across imaging modalities.
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Affiliation(s)
- Petya D Radoeva
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island
| | | | - Jeffrey I Hunt
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island
| | - Christopher H Legere
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island
| | - Sean C L Deoni
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Stephen J Sheinkopf
- Thompson Center for Autism & Neurodevelopment, University of Missouri, Columbia, Missouri
| | - Carla A Mazefsky
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Noah S Philip
- VA Providence Healthcare System, Providence, Rhode Island
| | - Daniel P Dickstein
- Pediatric Mood, Imaging, and NeuroDevelopment (Ped-iMIND) Program, McLean Hospital, Belmont, Massachusetts and Harvard Medical School, Boston, Massachusetts
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Shuster CL, Sheinkopf SJ, McGowan EC, Hofheimer JA, O'Shea TM, Carter BS, Helderman JB, Check J, Neal CR, Pastyrnak SL, Smith LM, Loncar C, Dansereau LM, DellaGrotta SA, Marsit C, Lester BM. Neurobehavioral and Medical Correlates of Autism Screening: 2-Year Outcomes for Infants Born Very Preterm. J Pediatr 2023; 260:113536. [PMID: 37271496 PMCID: PMC10526642 DOI: 10.1016/j.jpeds.2023.113536] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To identify neonatal characteristics and 2-year neurodevelopmental outcomes associated with positive screening for risk of autism. STUDY DESIGN Nine university-affiliated neonatal intensive care units (NICUs) enrolled infants born at <30 weeks of gestation. Infants underwent the NICU Network Neurobehavioral Scale examination before discharge and the Bayley Scales of Infant and Toddler Development, Third Edition, the Child Behavior Checklist, and the Modified Checklist for Autism in Toddlers, revised with follow-up (M-CHAT-R/F) at 2 years of corrected age. Generalized estimating equations examined associations between M-CHAT-R/F, neurobehavioral test results, and neonatal medical morbidities. RESULTS At 2 years of corrected age, data were available for 466 of 744 enrolled infants without cerebral palsy. Infants with hypoaroused NICU Network Neurobehavioral Scale profiles were more likely to screen M-CHAT-R/F-positive (OR 2.76, 95% CI 1.38-5.54). Infants with ≥2 medical morbidities also were more likely to screen positive (OR 2.65, 95% CI 1.27-5.54). Children with positive M-CHAT-R/F scores had lower Bayley Scales of Infant and Toddler Development, Third Edition, Cognitive (t [451] = 5.43, P < .001, d = 0.82), Language (t [53.49] = 7.82, P < .001, d = 1.18), and Motor (t [451] = 7.98, P < .001, d = 1.21) composite scores and significantly greater Child Behavior Checklist Internalizing (t [457] -6.19, P < .001, d = -0.93) and Externalizing (t [57.87] = -5.62, P < .001, d = -0.84) scores. CONCLUSIONS Positive M-CHAT-R/F screens at 2 years of corrected age were associated with neonatal medical morbidities and neurobehavioral examinations as well as toddler developmental and behavioral outcomes. These findings demonstrate the potential utility of the M-CHAT-R/F as a global developmental screener in infants born very preterm, regardless of whether there is a later autism diagnosis.
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Affiliation(s)
- Coral L Shuster
- Department of Pediatrics, Women and Infants Hospital, Providence, RI.
| | - Stephen J Sheinkopf
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO
| | | | | | - T Michael O'Shea
- Deparment of Pediatrics, UNC School of Medicine, Chapel Hill, NC
| | - Brian S Carter
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO
| | | | - Jennifer Check
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC
| | - Charles R Neal
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - Steven L Pastyrnak
- Department of Pediatrics, Spectrum Health-Helen Devos Hospital, Grand Rapids, MI
| | - Lynne M Smith
- Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles, CA
| | - Cynthia Loncar
- Department of Pediatrics, Brown Alpert Medical School, Providence, RI; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | - Lynne M Dansereau
- Department of Pediatrics, Women and Infants Hospital, Providence, RI
| | | | - Carmen Marsit
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA
| | - Barry M Lester
- Department of Pediatrics, Women and Infants Hospital, Providence, RI; Department of Pediatrics, Brown Alpert Medical School, Providence, RI; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
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6
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Camerota M, McGowan EC, Aschner J, Stroustrup A, Karagas MR, Conradt E, Crowell SE, Brennan PA, Carter BS, Check J, Dansereau LM, DellaGrotta SA, Everson TM, Helderman JB, Hofheimer JA, Kuiper JR, Loncar CM, Marsit CJ, Neal CR, O'Shea TM, Pastyrnak SL, Sheinkopf SJ, Smith LM, Zhang X, Lester BM. Prenatal and perinatal factors associated with neonatal neurobehavioral profiles in the ECHO Program. Pediatr Res 2023; 94:762-770. [PMID: 36841884 PMCID: PMC10440230 DOI: 10.1038/s41390-023-02540-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/23/2022] [Accepted: 02/06/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Single-cohort studies have identified distinct neurobehavioral profiles that are associated with prenatal and neonatal factors based on the NICU Network Neurobehavioral Scale (NNNS). We examined socioeconomic, medical, and substance use variables as predictors of NNNS profiles in a multi-cohort study of preterm and term-born infants with different perinatal exposures. METHODS We studied 1112 infants with a neonatal NNNS exam from the Environmental influences on Child Health Outcomes (ECHO) consortium. We used latent profile analysis to characterize infant neurobehavioral profiles and generalized estimating equations to determine predictors of NNNS profiles. RESULTS Six distinct neonatal neurobehavioral profiles were identified, including two dysregulated profiles: a hypo-aroused profile (16%) characterized by lethargy, hypotonicity, and nonoptimal reflexes; and a hyper-aroused profile (6%) characterized by high arousal, excitability, and stress, with low regulation and poor movement quality. Infants in the hypo-aroused profile were more likely to be male, have younger mothers, and have mothers who were depressed prenatally. Infants in the hyper-aroused profile were more likely to be Hispanic/Latino and have mothers who were depressed or used tobacco prenatally. CONCLUSIONS We identified two dysregulated neurobehavioral profiles with distinct perinatal antecedents. Further understanding of their etiology could inform targeted interventions to promote positive developmental outcomes. IMPACT Prior research on predictors of neonatal neurobehavior have included single-cohort studies, which limits generalizability of findings. In a multi-cohort study of preterm and term-born infants, we found six distinct neonatal neurobehavioral profiles, with two profiles being identified as dysregulated. Hypo- and hyper-aroused neurobehavioral profiles had distinct perinatal antecedents. Understanding perinatal factors associated with dysregulated neurobehavior could help promote positive developmental outcomes.
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Affiliation(s)
- Marie Camerota
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
- Department of Pediatrics, Women and Infants Hospital, Providence, RI, USA.
| | - Elisabeth C McGowan
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Judy Aschner
- Departments of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, USA
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Annemarie Stroustrup
- Division of Neonatology, Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Elisabeth Conradt
- Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | - Brian S Carter
- Department of Pediatrics-Neonatology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jennifer Check
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lynne M Dansereau
- Department of Pediatrics, Women and Infants Hospital, Providence, RI, USA
| | | | - Todd M Everson
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer B Helderman
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Julie A Hofheimer
- Department of Pediatrics, University of North Carolina and Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jordan R Kuiper
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cynthia M Loncar
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Carmen J Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Charles R Neal
- Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Thomas Michael O'Shea
- Department of Pediatrics, University of North Carolina and Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Steven L Pastyrnak
- Department of Pediatrics, Spectrum Health-Helen DeVos Hospital, Grand Rapids, MI, USA
| | - Stephen J Sheinkopf
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO, USA
| | - Lynne M Smith
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barry M Lester
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Women and Infants Hospital, Providence, RI, USA
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
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7
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Manigault AW, Sheinkopf SJ, Carter BS, Check J, Helderman J, Hofheimer JA, McGowan EC, Neal CR, O’Shea M, Pastyrnak S, Smith LM, Everson TM, Marsit CJ, Dansereau LM, DellaGrotta SA, Lester BM. Acoustic Cry Characteristics in Preterm Infants and Developmental and Behavioral Outcomes at 2 Years of Age. JAMA Netw Open 2023; 6:e2254151. [PMID: 36723941 PMCID: PMC9892956 DOI: 10.1001/jamanetworkopen.2022.54151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
IMPORTANCE Acoustic cry characteristics have been associated with severe medical problems in newborns. However, little is known about the utility of neonatal acoustic cry characteristics in the prediction of long-term outcomes of very preterm infants. OBJECTIVES To evaluate whether acoustic characteristics of infant cry at neonatal intensive care unit (NICU) discharge are associated with behavioral and developmental outcomes at age 2 years in infants born very preterm. DESIGN, SETTING, AND PARTICIPANTS Infants born less than 30 weeks postmenstrual age (PMA) were enrolled from April 2014 through June 2016 as part of a multicenter (9 US university affiliated NICUs) cohort study and followed to adjusted age 2 years. Reported analyses began on September 2021. Data were analyzed from September 2021 to September 2022. EXPOSURES The primary exposure was premature birth (<30 weeks PMA). MAIN OUTCOMES AND MEASURES Cries were recorded during a neurobehavioral examination administered during the week of NICU discharge. Cry episodes were analyzed using a previously published computerized system to characterize cry acoustics. Year-2 outcomes included the Bayley-III Composite scores, Child Behavior Checklist (CBCL) and the Modified Checklist for Autism in Toddlers (M-CHAT R/F), dichotomized using clinically significant cutoffs (<85 on Bayley Language, Cognitive and/or Motor Composite scores, T-score >63 on the CBCL Internalizing, Externalizing and/or Total Problem Scales and total M-CHAT R/F score >2). RESULTS Analyzed infants (363 participants) were primarily male (202 participants [55.65%]) and had a mean [SD] gestational age of 27.08 [1.95] weeks). Cross-validated random forest models revealed that cry acoustics were associated with 2-year outcomes. Tests of diagnostic odds ratios (DOR) revealed that infants who exhibited total problem behavior CBCL scores greater than 63 at age 2 years were 3.3 times more likely (95% CI, 1.44-7.49) to be identified as so by random forest model estimates relative to other infants (scores ≤63); this association was robust to adjustment for family-wise type-I error rates and covariate measures. Similar associations were observed for internalizing (DOR, 2.39; 95% CI, 1.04-5.47) and externalizing (DOR, 2.25; 95% CI, 1.12-4.54) scores on the CBCL, clinically significant language (DOR, 1.71; 95% CI, 1.10-2.67) and cognitive (DOR, 1.70; 95% CI, 1.00-2.88) scores on the Bayley-III, and a positive autism screen on the M-CHAT (DOR, 1.91; 95% CI, 1.05-3.44). CONCLUSIONS AND RELEVANCE In this cohort study of preterm infants, findings pointed to the potential use of acoustic cry characteristics in the early identification of risk for long-term developmental and behavioral deficits.
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Affiliation(s)
- Andrew W. Manigault
- Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence
| | - Stephen J. Sheinkopf
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia
| | | | - Jennifer Check
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Julie A. Hofheimer
- University of North Carolina Chapel Hill School of Medicine, Chapel Hill
| | - Elisabeth C. McGowan
- Departments of Psychiatry and Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Charles R. Neal
- University of Hawaii John A Burns School of Medicine, Honolulu, Hawaii
| | - Michael O’Shea
- University of North Carolina Chapel Hill School of Medicine, Chapel Hill
| | | | - Lynne M. Smith
- Harbor-University of California, Los Angeles Medical Center, Torrance
| | - Todd M. Everson
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carmen J. Marsit
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lynne M. Dansereau
- Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence
| | - Sheri A. DellaGrotta
- Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence
| | - Barry M. Lester
- Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence
- Departments of Psychiatry and Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island
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8
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Kavanaugh BC, Schremp CA, Jones RN, Best CR, Sheinkopf SJ, Morrow EM. Moderators of Age of Diagnosis in > 20,000 Females with Autism in Two Large US Studies. J Autism Dev Disord 2023; 53:864-869. [PMID: 33961180 DOI: 10.1007/s10803-021-05026-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
The objective of this study was to determine the clinical features that moderate a later age at ASD diagnosis in females in a large sample of females with ASD. Within two large and independent ASD datasets (> 20,000 females), females were first diagnosed with ASD 14-months later relative to males. This later age at diagnosis was moderated by a mild or atypical presentation, wherein repetitive behaviors were limited, IQ and language were broadly intact, and recognized symptoms emerged later in development. Females are at risk for a later age at ASD diagnosis and treatment implementation, and modification of early childhood ASD screening methods for females may be warranted.
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Affiliation(s)
- Brian C Kavanaugh
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, USA
| | - Christine A Schremp
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Carrie R Best
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, USA
| | - Stephen J Sheinkopf
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, RI, USA.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Eric M Morrow
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA. .,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. .,Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, USA. .,Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI, USA. .,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, RI, USA. .,Laboratories for Molecular Medicine, Brown University, 70 Ship Street, Providence, RI, 02912, USA.
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9
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Saletin JM, Koopman-Verhoeff ME, Han G, Barker DH, Carskadon MA, Anders TF, Sheinkopf SJ. Sleep Problems and Autism Impairments in a Large Community Sample of Children and Adolescents. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01470-0. [PMID: 36515855 DOI: 10.1007/s10578-022-01470-0] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 12/15/2022]
Abstract
Sleep problems are common in individuals with autism spectrum disorder (ASD). How sleep problems reflect specific ASD phenotypes is unclear. We studied whether sleep problems indexed functional impairment in a heterogeneous community sample of individuals with ASD. We analyzed 977 probands (233 females; age = 11.27 ± 4.13 years) from the Rhode Island Consortium for Autism Research and Treatment dataset, a unique public-private-academic collaboration involving all major points of service for families in Rhode Island. We found that individuals with a confirmed diagnosis of ASD were more likely to have sleep problems. However, across the whole sample and above and beyond a formal diagnosis, sleep problems were dimensionally associated with worse social impairment and poorer adaptive functioning. By using a large dataset reflective of the diversity of presentations in the community, this study underscores the importance of considering sleep problems in clinical practice to improve adaptive functioning in individuals with ASD.
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Affiliation(s)
- Jared M Saletin
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
- Emma Pendleton Bradley Hospital, East Providence, RI, USA.
- Sleep Research Laboratory, Emma Pendleton Bradley Hospital, Providence, RI, USA.
| | - M Elisabeth Koopman-Verhoeff
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, East Providence, RI, USA
- Sleep Research Laboratory, Emma Pendleton Bradley Hospital, Providence, RI, USA
| | - Gloria Han
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Anesthesiology, Vanderbilt Medical Center, Nashville, TN, USA
| | - David H Barker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- The Bradley Hasbro Children's Research Center, Providence, RI, USA
| | - Mary A Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, East Providence, RI, USA
- Sleep Research Laboratory, Emma Pendleton Bradley Hospital, Providence, RI, USA
| | - Thomas F Anders
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Stephen J Sheinkopf
- Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, RI, USA
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO, USA
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10
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Naples A, Tenenbaum EJ, Jones RN, Righi G, Sheinkopf SJ, Eigsti IM. Exploring communicative competence in autistic children who are minimally verbal: The Low Verbal Investigatory Survey for Autism (LVIS). Autism 2022:13623613221136657. [PMID: 36373838 PMCID: PMC10183057 DOI: 10.1177/13623613221136657] [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: 11/16/2022]
Abstract
LAY ABSTRACT Approximately one in three autistic children is unable to communicate with language; this state is often described as minimally verbal. Despite the tremendous clinical implications, we cannot predict whether a minimally verbal child is simply delayed (but will eventually develop spoken language) or will continue to struggle with verbal language, and might therefore benefit from learning an alternative form of communication. This is important for clinicians to know, to be able to choose the most helpful interventions, such as alternative forms of communication. In addition, the field lacks a standard definition of "minimally verbal." Even when we do agree on what the term means (e.g. fewer than 20 words), describing a child based on their lack of words does not tell us whether that child is communicating in other ways or how they are using those 20 words. To address these concerns, we developed the Low Verbal Investigatory Survey (LVIS), a one-page parent-report measure designed to help us characterize how minimally verbal autistic children are communicating. Parents of 147 children (aged 1-8 years) completed the LVIS. Here, we ask (1) whether the survey measures what it was designed to measure, that is, communicative ability in children without much spoken language, and (2) how the LVIS relates to cognitive and language ability, and symptoms of autism. Results suggest that this survey, which takes only 5 min to complete, is a good estimate of the child's communication skills. Furthermore, LVIS survey scores are correlated with other measures of language and cognitive abilities as well as autism symptomatology. The LVIS has the potential to save time and money in both clinical and research efforts to assess communication skills in minimally verbal autistic children.
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Affiliation(s)
| | - Elena J Tenenbaum
- Women & Infants Hospital, USA.,Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Duke University Medical Center, USA
| | | | - Giulia Righi
- Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Brown University, USA
| | - Stephen J Sheinkopf
- Women & Infants Hospital, USA.,Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Brown University, USA.,University of Missouri, USA
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11
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Manigault AW, Sheinkopf SJ, Silverman HF, Lester BM. Newborn Cry Acoustics in the Assessment of Neonatal Opioid Withdrawal Syndrome Using Machine Learning. JAMA Netw Open 2022; 5:e2238783. [PMID: 36301544 PMCID: PMC9614579 DOI: 10.1001/jamanetworkopen.2022.38783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The assessment of opioid withdrawal in the neonate, or neonatal opioid withdrawal syndrome (NOWS), is problematic because current assessment methods are based on subjective observer ratings. Crying is a distinctive component of NOWS assessment tools and can be measured objectively using acoustic analysis. OBJECTIVE To evaluate the feasibility of using newborn cry acoustics (acoustics referring to the physical properties of sound) as an objective biobehavioral marker of NOWS. DESIGN, SETTING, AND PARTICIPANTS This prospective controlled cohort study assessed whether acoustic analysis of neonate cries could predict which infants would receive pharmacological treatment for NOWS. A total of 177 full-term neonates exposed and not exposed to opioids were recruited from Women & Infants Hospital of Rhode Island between August 8, 2016, and March 18, 2020. Cry recordings were processed for 118 neonates, and 65 neonates were included in the final analyses. Neonates exposed to opioids were monitored for signs of NOWS using the Finnegan Neonatal Abstinence Scoring Tool administered every 3 hours as part of a 5-day observation period during which audio was recorded continuously to capture crying. Crying of healthy neonates was recorded before hospital discharge during routine handling (eg, diaper changes). EXPOSURES The primary exposure was prenatal opioid exposure as determined by maternal receipt of medication-assisted treatment with methadone or buprenorphine. MAIN OUTCOMES AND MEASURES Neonates were stratified by prenatal opioid exposure and receipt of pharmacological treatment for NOWS before discharge from the hospital. In total, 775 hours of audio were collected and trimmed into 2.5 hours of usable cries, then acoustically analyzed (using 2 separate acoustic analyzers). Cross-validated supervised machine learning methods (combining the Boruta algorithm and a random forest classifier) were used to identify relevant acoustic parameters and predict pharmacological treatment for NOWS. RESULTS Final analyses included 65 neonates (mean [SD] gestational age at birth, 36.6 [1.1] weeks; 36 [55.4%] female; 50 [76.9%] White) with usable cry recordings. Of those, 19 neonates received pharmacological treatment for NOWS, 7 neonates were exposed to opioids but did not receive pharmacological treatment for NOWS, and 39 healthy neonates were not exposed to opioids. The mean of the predictions of random forest classifiers predicted receipt of pharmacological treatment for NOWS with high diagnostic accuracy (area under the curve, 0.90 [95% CI, 0.83-0.98]; accuracy, 0.85 [95% CI, 0.74-0.92]; sensitivity, 0.89 [95% CI, 0.67-0.99]; specificity, 0.83 [95% CI, 0.69-0.92]). CONCLUSIONS AND RELEVANCE In this study, newborn acoustic cry analysis had potential as an objective measure of opioid withdrawal. These findings suggest that acoustic cry analysis using machine learning could improve the assessment, diagnosis, and management of NOWS and facilitate standardized care for these infants.
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Affiliation(s)
- Andrew W. Manigault
- Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, Providence
| | - Stephen J. Sheinkopf
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia
| | | | - Barry M. Lester
- Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, Providence
- Department of Psychiatry, Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island
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12
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Lyall K, Ning X, Aschner JL, Avalos LA, Bennett DH, Bilder DA, Bush NR, Carroll KN, Chu SH, Croen LA, Dabelea D, Daniels JL, Duarte C, Elliott AJ, Fallin MD, Ferrara A, Hertz-Picciotto I, Hipwell AE, Jensen ET, Johnson SL, Joseph RM, Karagas M, Kelly RS, Lester BM, Margolis A, McEvoy CT, Messinger D, Neiderhiser JM, O’Connor TG, Oken E, Sathyanarayana S, Schmidt RJ, Sheinkopf SJ, Talge NM, Turi KN, Wright RJ, Zhao Q, Newschaffer C, Volk HE, Ladd-Acosta C, Environmental Influences on Child Health Outcomes OBOPCF. Cardiometabolic Pregnancy Complications in Association With Autism-Related Traits as Measured by the Social Responsiveness Scale in ECHO. Am J Epidemiol 2022; 191:1407-1419. [PMID: 35362025 PMCID: PMC9614927 DOI: 10.1093/aje/kwac061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/07/2022] [Accepted: 03/25/2022] [Indexed: 01/28/2023] Open
Abstract
Prior work has examined associations between cardiometabolic pregnancy complications and autism spectrum disorder (ASD) but not how these complications may relate to social communication traits more broadly. We addressed this question within the Environmental Influences on Child Health Outcomes program, with 6,778 participants from 40 cohorts conducted from 1998-2021 with information on ASD-related traits via the Social Responsiveness Scale. Four metabolic pregnancy complications were examined individually, and combined, in association with Social Responsiveness Scale scores, using crude and adjusted linear regression as well as quantile regression analyses. We also examined associations stratified by ASD diagnosis, and potential mediation by preterm birth and low birth weight, and modification by child sex and enriched risk of ASD. Increases in ASD-related traits were associated with obesity (β = 4.64, 95% confidence interval: 3.27, 6.01) and gestational diabetes (β = 5.21, 95% confidence interval: 2.41, 8.02), specifically, but not with hypertension or preeclampsia. Results among children without ASD were similar to main analyses, but weaker among ASD cases. There was not strong evidence for mediation or modification. Results suggest that common cardiometabolic pregnancy complications may influence child ASD-related traits, not only above a diagnostic threshold relevant to ASD but also across the population.
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Affiliation(s)
- Kristen Lyall
- Correspondence to Dr. Kristen Lyall, 3020 Market Street, Suite 560, Philadelphia, PA 19104 (e-mail: )
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13
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Kavanaugh BC, Gabert T, Jones RN, Sheinkopf SJ, Morrow EM. Parental age and autism severity in the Rhode Island Consortium for Autism Research and Treatment (RI-CART) study. Autism Res 2021; 15:86-92. [PMID: 34866351 DOI: 10.1002/aur.2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/22/2021] [Accepted: 11/16/2021] [Indexed: 11/10/2022]
Abstract
Advanced parental age at offspring birth has been associated with autism spectrum disorder (ASD). The objective of the current study was to investigate associations between parental age at birth and autism severity. The Rhode Island Consortium for Autism Research and Treatment (RI-CART) study represents a community-based sample with a range of autism severity, including participants with and without ASD. This study involved participants (n = 1178) enrolled in RI-CART with available mother and father ages at birth. Primary data points included the age of mother and father at the participant's birth and results from the Autism Diagnostic Observation Schedule - Second Edition (ADOS-2). Mothers were 1.7 years older at the time of birth of the child with ASD, as compared to mothers of offspring without ASD. Fathers of children with ASD were 1.6 years older at the time of birth than fathers of children without ASD. The age of both parents at offspring birth displayed a positive, statistically significant association with overall ASD severity and the severity of restricted/repetitive behaviors. This finding was driven by the association between parental age and the severity of compulsions or rituals. Intelligence and adaptive functioning did not moderate the relationship between parental age and ASD severity. This study extends prior research to show that advanced parental age at birth is associated with the severity as well as the presence of ASD in offspring.
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Affiliation(s)
- Brian C Kavanaugh
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA
| | - Tess Gabert
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA
| | | | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Quantitative Sciences Program, Department of Psychiatry and Human Behavior and Department of Neurology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Stephen J Sheinkopf
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Eric M Morrow
- Developmental Disorders Genetics Research Program, Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA.,Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, USA.,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island, USA
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14
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Mitsven SG, Prince EB, Messinger DS, Tenenbaum EJ, Sheinkopf SJ, Tronick EZ, Seifer R, Lester BM. Testing the mid-range model: Attachment in a high risk sample. Dev Sci 2021; 25:e13185. [PMID: 34743364 PMCID: PMC9012671 DOI: 10.1111/desc.13185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/14/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
Infant attachment is a key predictor of later socioemotional functioning, but it is not clear how parental responsivity to infant expressive behavior is associated with attachment outcomes. A mid-range model of responsivity holds that both unresponsive and highly reactive parental behaviors lead to insecure and disorganized attachment. We examined the relationship between maternal (and infant) contingent responsivity and attachment in a high-risk sample. Participants were 625 infant-mother pairs from a longitudinal study of children with and without prenatal drug exposure and variable levels of associated social risks. Infant-mother pairs participated in the Face-to-Face/Still-Face paradigm (FFSF) at 4-months and in the Strange Situation Procedure (SSP) at 18-months. A model incorporating both linear and quadratic responsivity effects indicated that mothers who were either very high (reactive) or very low (unresponsive) in responsivity were more likely to have infants with disorganized attachment outcomes. While maternal responsivity was associated with attachment disorganization, no associations between maternal responsivity, and attachment security/insecurity were detected. Infant responsivity to mother was not associated with attachment outcomes. The findings suggest the importance of mid-range levels of maternal responsivity in the development of organized attachment among infants facing high levels of prenatal and social risk.
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Affiliation(s)
- Samantha G Mitsven
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Emily B Prince
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Daniel S Messinger
- Department of Psychology, University of Miami, Coral Gables, Florida, USA.,Department of Electrical and Computer Engineering, University of Miami, Coral Gables, Florida, USA.,Department of Pediatrics, Department of Music Engineering, University of Miami, Coral Gables, Florida, USA
| | - Elena J Tenenbaum
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Stephen J Sheinkopf
- Department of Psychiatry & Human Behavior and Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Edward Z Tronick
- Department of Psychology, University of Massachusetts, Boston, Massachusetts, USA
| | - Ronald Seifer
- Frank Porter Graham Child Development Institute, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Barry M Lester
- Department of Psychiatry & Human Behavior and Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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15
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Sipsock D, Tokadjian H, Righi G, Morrow EM, Sheinkopf SJ. Autism severity aggregates with family psychiatric history in a community-based autism sample. Autism Res 2021; 14:2524-2532. [PMID: 34652072 DOI: 10.1002/aur.2625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/01/2021] [Accepted: 09/18/2021] [Indexed: 01/04/2023]
Abstract
The purpose of this study was to examine family psychiatric history in individuals with autism spectrum disorder (ASD) and its association with clinical presentation. Participants were 798 individuals with a clinical diagnosis of ASD, confirmed by the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), enrolled in Rhode Island Consortium for Autism Research and Treatment, a statewide research registry. Prior research suggests a specific behavioral phenotype in individuals with ASD who have family members with psychiatric diagnoses, including higher IQ and less severe language impairment. However, studies have not specifically investigated autism severity. We hypothesized that increased psychiatric family history would be associated with increased autism severity symptoms. Results show a strong association of increased burden of first-degree family psychiatric history with higher autism symptom severity as measured by Social Responsiveness Scale, Second Edition (SRS-2), but not with ADOS-2 severity scores, IQ, or adaptive functioning. These findings support the importance of investigating the contribution of psychiatric family history toward clinical ASD presentation. LAY SUMMARY: This study explored how family psychiatric history is related to clinical presentation of Autism Spectrum Disorder (ASD). Higher amounts of first-degree family psychiatric history was associated with higher autism symptom severity as measured by the Social Responsiveness Scale, Second Edition (SRS-2). The contribution of psychiatric family history requires ongoing investigation.
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Affiliation(s)
- Danielle Sipsock
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA
| | - Hasmik Tokadjian
- Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA
| | - Giulia Righi
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA
| | - Eric M Morrow
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA.,Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, USA.,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island, USA
| | - Stephen J Sheinkopf
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island, USA
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16
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Affiliation(s)
| | - Stephen J Sheinkopf
- Women & Infants Hospital.,Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk
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17
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Aghagoli G, Sheinkopf SJ, Everson TM, Marsit CJ, Lee H, Burt AA, Carter BS, Helderman JB, Hofheimer JA, McGowan EC, Neal CR, O’Shea TM, Pastyrnak SL, Smith LM, Soliman A, Dansereau LM, DellaGrotta SA, Padbury JF, Lester BM. Epigenome-wide analysis identifies genes and pathways linked to acoustic cry variation in preterm infants. Pediatr Res 2021; 89:1848-1854. [PMID: 32967004 PMCID: PMC7985041 DOI: 10.1038/s41390-020-01172-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/23/2020] [Accepted: 09/01/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Preterm birth places infants at higher risk of adverse long-term behavioral and cognitive outcomes. Combining biobehavioral measures and molecular biomarkers may improve tools to predict the risk of long-term developmental delays. METHODS The Neonatal Neurobehavior and Outcomes in Very Preterm Infants study was conducted at nine neonatal intensive care units between April 2014 and June 2016. Cries were recorded and buccal swabs collected during the neurobehavioral exam. Cry episodes were extracted and analyzed using a computer system and the data were summarized using factor analysis. Genomic DNA was extracted from buccal swabs, quantified using the Qubit Fluorometer, and aliquoted into standardized concentrations. DNA methylation was measured with the Illumina MethylationEPIC BeadArray, and an epigenome-wide association study was performed using cry factors (n = 335). RESULTS Eighteen CpGs were associated with the cry factors at genome-wide significance (α = 7.08E - 09). Two CpG sites, one intergenic and one linked to gene TCF3 (important for B and T lymphocyte development), were associated with acoustic measures of cry energy. Increased methylation of TCF3 was associated with a lower energy-related cry factor. We also found that pitch (F0) and hyperpitch (F0 > 1 kHz) were associated with DNA methylation variability at 16 CpG sites. CONCLUSIONS Acoustic cry characteristics are related to variation in DNA methylation in preterm infants. IMPACT Preterm birth is a major public health problem and its long-term impact on health is not well understood. Cry acoustics, related to prematurity, has been linked to a variety of medical conditions. Biobehavioral measures and molecular biomarkers can improve prediction tools for long-term developmental risks of preterm birth. Variation in epigenetic modulation in preterm infants provides a potential link between preterm birth and unfavorable developmental outcomes.
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Affiliation(s)
- Ghazal Aghagoli
- Brown Center for the Study of Children at Risk, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI
| | - Stephen J. Sheinkopf
- Brown Center for the Study of Children at Risk, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
| | - Todd M. Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Carmen J. Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Hannah Lee
- Brown Center for the Study of Children at Risk, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI
| | - Amber A. Burt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Brian S. Carter
- Department of Pediatrics-Neonatology, Children’s Mercy Hospital, Kansas City, MO
| | | | - Julie A. Hofheimer
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Elisabeth C. McGowan
- Brown Center for the Study of Children at Risk, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI
| | - Charles R. Neal
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Steve L. Pastyrnak
- Department of Pediatrics, Spectrum Health-Helen DeVos Hospital, Grand Rapids, MI
| | - Lynne M Smith
- Department of Pediatrics, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Antoine Soliman
- Department of Pediatrics, Miller Children’s and Women’s Hospital Long Beach, Long Beach, CA
| | - Lynne M. Dansereau
- Brown Center for the Study of Children at Risk, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI
| | - Sheri A DellaGrotta
- Brown Center for the Study of Children at Risk, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI
| | - James F. Padbury
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI
| | - Barry M. Lester
- Brown Center for the Study of Children at Risk, Providence, RI,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI,Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
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18
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Moreno-De-Luca D, Kavanaugh BC, Best CR, Sheinkopf SJ, Phornphutkul C, Morrow EM. Clinical Genetic Testing in Autism Spectrum Disorder in a Large Community-Based Population Sample. JAMA Psychiatry 2020; 77:979-981. [PMID: 32401282 PMCID: PMC7221847 DOI: 10.1001/jamapsychiatry.2020.0950] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study analyzes data from a large, population-based study of people with autism spectrum disorder to evaluate what proportion underwent genetic testing.
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Affiliation(s)
- Daniel Moreno-De-Luca
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island,Emma Pendleton Bradley Hospital, East Providence, Rhode Island,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island
| | - Brian C. Kavanaugh
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island,Emma Pendleton Bradley Hospital, East Providence, Rhode Island,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island
| | - Carrie R. Best
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island,Emma Pendleton Bradley Hospital, East Providence, Rhode Island,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island
| | - Stephen J. Sheinkopf
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island,Emma Pendleton Bradley Hospital, East Providence, Rhode Island,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island,Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island, Providence
| | - Chanika Phornphutkul
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island,Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island,Division of Human Genetics, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence
| | - Eric M. Morrow
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island,Emma Pendleton Bradley Hospital, East Providence, Rhode Island,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island,Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island
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19
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Saletin JM, Koopman-Verhoeff M, Han G, Barker DH, Carskadon MA, Anders TF, Sheinkopf SJ. 1002 Endorsement Of Sleep Problems Indexes Autism Severity In Children And Adolescents: Evidence From A Large Community Sample. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Individuals with autism spectrum disorder (ASD) often experience sleep problems. A reliance on case-control studies rather than dimensional samples limit our ability to understand how sleep problems distinguish diagnosis and severity of ASD. To address this need, we present preliminary findings from a large community sample of individuals with heterogeneous autism phenotypes.
Methods
All participants (≤ 21 years) were selected from the Rhode Island Consortium for Autism Research and Treatment (RI-CART) (final n= 977; 233F; 11.27±4.13 years), a public-private-academic registry of families in Rhode Island affected by ASD-like symptoms. Participants completed the Autism Diagnostic Observation Schedule, 2nd Edition to confirm the presence of diagnosable ASD. Each caretaker also completed dimensional measures of functional impairment: Social Responsiveness Scale, 2nd edition and the Vineland Adaptive Behavior Scale (2nd/3rd editions). Caretakers were asked whether the participant suffered current/past sleep problems: yes/no. All analyses are adjusted for age, sex, race, ethnicity, caregiver education, and scale-version (e.g., 2nd/3rd ed., where applicable).
Results
Endorsement of sleep problems distinguished ASD diagnosis: a confirmed diagnosis of ASD was associated with greater prevalence of sleep problems compared to ASD diagnosis (OR: 1.58; 95% CI: 1.05,2.38; p = .028). Across the sample, endorsement of sleep problems was associated with impairments in adaptive behavior (b = -4.73; 95% CI: -7.47,-2.00045; p = .001) and social responsiveness (b = 6.72; 95% CI: 3.27,10.16; p < .001).
Conclusion
These data from a heterogenous community sample provide evidence for a link of sleep to the phenomenology of ASD. While the search for better diagnostic indicators of ASD continues, we recommend that clinicians consider a brief assessment of sleep behaviors of patients with such neurodevelopmental conditions as autism.
Support
Simons Foundation Autism Research Initiative, Hassenfeld Child Health Innovation Institute at Brown University. K01MH109854 (JMS), NIGMS Advance CTR (JMS). KNAW Ter Meulen Grant (MEKV).
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Affiliation(s)
| | | | - G Han
- Brown University, Providence, RI
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20
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McCormick CEB, Kavanaugh BC, Sipsock D, Righi G, Oberman LM, Moreno De Luca D, Gamsiz Uzun ED, Best CR, Jerskey BA, Quinn JG, Jewel SB, Wu PC, McLean RL, Levine TP, Tokadjian H, Perkins KA, Clarke EB, Dunn B, Gerber AH, Tenenbaum EJ, Anders TF, Sheinkopf SJ, Morrow EM. Autism Heterogeneity in a Densely Sampled U.S. Population: Results From the First 1,000 Participants in the RI-CART Study. Autism Res 2020; 13:474-488. [PMID: 31957984 DOI: 10.1002/aur.2261] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/16/2019] [Accepted: 12/23/2019] [Indexed: 01/25/2023]
Abstract
The objective of this study was to establish a large, densely sampled, U.S. population-based cohort of people with autism spectrum disorder (ASD). The Rhode Island Consortium for Autism Research and Treatment (RI-CART) represents a unique public-private-academic collaboration involving all major points of service for families in Rhode Island affected by ASD. Diagnosis was based on direct behavioral observation via the Autism Diagnostic Observation Schedule, Second Edition. For the first 1,000 participants, ages ranged from 21 months to 64 years. Using Geographic Information System and published prevalence rates, the overall cohort is estimated to represent between 20% and 49% of pediatric age persons in Rhode Island with ASD, with demographics representative of U.S. Census. We observed a high rate of co-occurring medical and psychiatric conditions in affected individuals. Among the most prominent findings of immediate clinical importance, we found that females received a first diagnosis of ASD at a later age than males, potentially due to more advanced language abilities in females with ASD. In summary, this is the first analysis of a large, population-based U.S. cohort with ASD. Given the depth of sampling, the RI-CART study reflects an important new resource for studying ASD in a representative U.S. population. Psychiatric and medical comorbidities in ASD constitute a substantial burden and warrant adequate attention as part of overall treatment. Our study also suggests that new strategies for earlier diagnosis of ASD in females may be warranted. Autism Res 2020, 13: 474-488. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The Rhode Island Consortium for Autism Research and Treatment (RI-CART) represents a unique public-private-academic collaboration involving all major points of service for families in Rhode Island affected by autism spectrum disorder (ASD). In this article, we provide results from the first 1,000 participants, estimated to represent >20% of affected families in the state. Importantly, we find a later age at first diagnosis of ASD in females, which potentially calls attention to the need for improved early diagnosis in girls. Also, we report a high rate of co-occurring medical and psychiatric conditions in affected individuals.
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Affiliation(s)
- Carolyn E B McCormick
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Brian C Kavanaugh
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Danielle Sipsock
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Giulia Righi
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Lindsay M Oberman
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Daniel Moreno De Luca
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Ece D Gamsiz Uzun
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, Rhode Island.,Center for Computational Molecular Biology, Brown University, Providence, Rhode Island
| | - Carrie R Best
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Beth A Jerskey
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | - Pei-Chi Wu
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island.,Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island
| | - Rebecca L McLean
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Todd P Levine
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Hasmik Tokadjian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Kayla A Perkins
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Elaine B Clarke
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island
| | - Brittany Dunn
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Alan H Gerber
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Elena J Tenenbaum
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Thomas F Anders
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Stephen J Sheinkopf
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island
| | - Eric M Morrow
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island.,Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island.,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island
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21
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Aghagoli G, Conradt E, Padbury JF, Sheinkopf SJ, Tokadjian H, Dansereau LM, Tronick EZ, Marsit CJ, Lester BM. Social Stress-Related Epigenetic Changes Associated With Increased Heart Rate Variability in Infants. Front Behav Neurosci 2020; 13:294. [PMID: 32009914 PMCID: PMC6974792 DOI: 10.3389/fnbeh.2019.00294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 12/23/2019] [Indexed: 12/17/2022] Open
Abstract
Early life stress can result in persistent alterations of an individual’s stress regulation through epigenetic modifications. Epigenetic alteration of the NR3C1 gene is associated with changes in the stress response system during infancy as measured by cortisol reactivity. Although autonomic nervous system (ANS) reactivity is a key component of the stress response, we have a limited understanding of the effects of NR3C1 DNA methylation on ANS reactivity. To examine this relation, ANS stress responses of term, 4–5-month-old healthy infants were elicited using the face-to-face still-face paradigm, which involved five, 2-min episodes. Two of these episodes were the “still-face” in which the mother was non-responsive to her infant. EKG was acquired continuously and analyzed in 30 s-intervals. Cheek swabs were collected, and DNA was extracted from buccal cells. Respiratory sinus arrhythmia (RSA) was measured as heart rate variability (HRV). Mean HRV was calculated for each 30-s “face to face” episode. DNA methylation of NR3C1 was calculated using bisulfite pyrosequencing. Percent DNA methylation was computed for each of the 13 NR3C1 CpG sites. The relations between mean HRV for each “face to face” episode and percent DNA methylation was examined averaged over CpG sites 1–6 and 7–13 and at each individual CpG site. Higher HRV at baseline, first reunion, and second still-face was related to greater methylation of NR3C1 CpG sites 1–6. Higher HRV at the second reunion was related to greater methylation of NR3C1 CpG sites 12 and 13. These data provide evidence that increased methylation of NR3C1 at CpG sites 12 and 13 are associated with increased activation of parasympathetic pathways as represented by increased HRV.
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Affiliation(s)
- Ghazal Aghagoli
- Brown Center for the Study of Children at Risk, Brown University, Providence, RI, United States.,Department of Neuroscience, Brown University, Providence, RI, United States
| | - Elisabeth Conradt
- Departments of Psychology, Pediatrics, and Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, United States
| | - James F Padbury
- Warren Alpert Medical School, Brown University, Providence, RI, United States.,Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, United States
| | - Stephen J Sheinkopf
- Brown Center for the Study of Children at Risk, Brown University, Providence, RI, United States.,Warren Alpert Medical School, Brown University, Providence, RI, United States.,Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, United States
| | - Hasmik Tokadjian
- Brown Center for the Study of Children at Risk, Brown University, Providence, RI, United States.,Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, United States
| | - Lynne M Dansereau
- Brown Center for the Study of Children at Risk, Brown University, Providence, RI, United States.,Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, United States
| | - Edward Z Tronick
- Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Carmen J Marsit
- Department of Environmental Health, Emory University, Atlanta, GA, United States
| | - Barry M Lester
- Brown Center for the Study of Children at Risk, Brown University, Providence, RI, United States.,Warren Alpert Medical School, Brown University, Providence, RI, United States.,Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, United States
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22
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Sheinkopf SJ, Levine TP, McCormick CEB, Puggioni G, Conradt E, Lagasse LL, Lester BM. Developmental trajectories of autonomic functioning in autism from birth to early childhood. Biol Psychol 2019; 142:13-18. [PMID: 30641105 PMCID: PMC6401242 DOI: 10.1016/j.biopsycho.2019.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 05/23/2018] [Revised: 11/05/2018] [Accepted: 01/10/2019] [Indexed: 01/12/2023]
Abstract
Deficits in social engagement emerge in autism during the infant and toddler period and may be related to emotion regulation and stress response systems. This study examined patterns of growth in autonomic functioning related to autism diagnosis and addresses the hypothesis that there are differences in autonomic functioning related to autism in infancy. Heart rate (HR) and respiratory sinus arrhythmia (RSA) were measured at 8 time points from 1 to 72 months of age in infants later diagnosed with autism (n = 12) and a non-autistic comparison group (n = 106). Multilevel models were used to describe the developmental course of HR and RSA and to test the effect of autism diagnosis on growth trajectories. Both groups showed an expected age-related decrease in HR and increase in RSA. Groups did not differ in the rate of decrease of HR over time. However, infants with autism demonstrated a smaller linear increase in RSA, indicating slower growth in RSA over time in comparison to controls. These results suggest that differences in physiological regulation may develop with age in autism. The slowed RSA growth in autism was most evident after 18 months of age, at a time when behavioral symptoms become prominent. This is consistent with the view that RSA is a marker of functional status in autism rather than a cause of social deficits in autism.
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Affiliation(s)
- Stephen J Sheinkopf
- Brown Center for the Study of Children at Risk, Women and Infants Hospital and the Rhode Island Consortium for Autism Research and Treatment, Providence, RI, United States; Department of Psychiatry & Human Behavior and Department of Pediatrics, Warren Alpert Medical School of Brown University, United States.
| | - Todd P Levine
- Brown Center for the Study of Children at Risk, Women and Infants Hospital and the Rhode Island Consortium for Autism Research and Treatment, Providence, RI, United States; Department of Psychiatry & Human Behavior and Department of Pediatrics, Warren Alpert Medical School of Brown University, United States
| | - Carolyn E B McCormick
- Brown Center for the Study of Children at Risk, Women and Infants Hospital and the Rhode Island Consortium for Autism Research and Treatment, Providence, RI, United States; Department of Human Development and Family Studies, Purdue University, United States
| | - Gavino Puggioni
- Department of Computer Science and Statistics, University of Rhode Island, United States
| | - Elisabeth Conradt
- Brown Center for the Study of Children at Risk, Women and Infants Hospital and the Rhode Island Consortium for Autism Research and Treatment, Providence, RI, United States; Department of Psychology, University of Utah, United States
| | - Linda L Lagasse
- Brown Center for the Study of Children at Risk, Women and Infants Hospital and the Rhode Island Consortium for Autism Research and Treatment, Providence, RI, United States; Department of Pediatrics and Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, United States
| | - Barry M Lester
- Brown Center for the Study of Children at Risk, Women and Infants Hospital and the Rhode Island Consortium for Autism Research and Treatment, Providence, RI, United States; Department of Psychiatry & Human Behavior and Department of Pediatrics, Warren Alpert Medical School of Brown University, United States
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23
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Righi G, Benevides J, Mazefsky C, Siegel M, Sheinkopf SJ, Morrow EM. Predictors of Inpatient Psychiatric Hospitalization for Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:3647-3657. [PMID: 28536960 DOI: 10.1007/s10803-017-3154-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/28/2022]
Abstract
Autism Spectrum Disorder (ASD) is associated with significant healthcare expenditures and a greater utilization of psychiatric health services. High utilization may not be evenly distributed across individuals with ASD. The objective of this study was to identify individual and family characteristics that increase the risk of psychiatric hospitalization. Naturalistic study of two age- and gender-matched ASD cohorts, inpatients enrolled in the Autism Inpatient Collection (AIC) and outpatients enrolled in the Rhode Island Consortium of Autism Research and Treatment (RI-CART), revealed a number of factors associated with hospitalization. Multiple logistic regression analyses revealed that adaptive functioning, ASD symptom severity, primary caregiver's marital status, the presence of mood disorders, and the presence of sleep problems independently increased the risk of psychiatric hospitalization.
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Affiliation(s)
- Giulia Righi
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA. .,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA. .,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.
| | - Jill Benevides
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA
| | - Carla Mazefsky
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Matthew Siegel
- Maine Medical Center Research Institute, Spring Harbor Hospital, Tufts University School of Medicine, 123 Andover Road, Westbrook, ME, 04092, USA
| | - Stephen J Sheinkopf
- Women and Infant's Hospital, 101 Dudley street, Providence, RI, 02905, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA.,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.,Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute, Alpert Medical School of Brown University, 101 Dudley street, Providence, RI, 02905, USA
| | - Eric M Morrow
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA.,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA
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24
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Righi G, Tenenbaum EJ, McCormick C, Megan B, Amso D, Sheinkopf SJ. Sensitivity to audio-visual synchrony and its relation to language abilities in children with and without ASD. Autism Res 2018; 11:645-653. [PMID: 29331093 PMCID: PMC10862227 DOI: 10.1002/aur.1918] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 02/18/2017] [Revised: 11/08/2017] [Accepted: 11/28/2017] [Indexed: 11/09/2022]
Abstract
Autism Spectrum Disorder (ASD) is often accompanied by deficits in speech and language processing. Speech processing relies heavily on the integration of auditory and visual information, and it has been suggested that the ability to detect correspondence between auditory and visual signals helps to lay the foundation for successful language development. The goal of the present study was to examine whether young children with ASD show reduced sensitivity to temporal asynchronies in a speech processing task when compared to typically developing controls, and to examine how this sensitivity might relate to language proficiency. Using automated eye tracking methods, we found that children with ASD failed to demonstrate sensitivity to asynchronies of 0.3s, 0.6s, or 1.0s between a video of a woman speaking and the corresponding audio track. In contrast, typically developing children who were language-matched to the ASD group, were sensitive to both 0.6s and 1.0s asynchronies. We also demonstrated that individual differences in sensitivity to audiovisual asynchronies and individual differences in orientation to relevant facial features were both correlated with scores on a standardized measure of language abilities. Results are discussed in the context of attention to visual language and audio-visual processing as potential precursors to language impairment in ASD. Autism Res 2018, 11: 645-653. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Speech processing relies heavily on the integration of auditory and visual information, and it has been suggested that the ability to detect correspondence between auditory and visual signals helps to lay the foundation for successful language development. The goal of the present study was to explore whether children with ASD process audio-visual synchrony in ways comparable to their typically developing peers, and the relationship between preference for synchrony and language ability. Results showed that there are differences in attention to audiovisual synchrony between typically developing children and children with ASD. Preference for synchrony was related to the language abilities of children across groups.
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Affiliation(s)
- Giulia Righi
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
- Bradley Hospital, Providence RI
- Rhode Island Consortium for Autism Research and Treatment, East Providence, RI
| | - Elena J. Tenenbaum
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
- Brown Center for the Study of Children at Risk at Women and Infants Hospital
- Rhode Island Consortium for Autism Research and Treatment, East Providence, RI
| | - Carolyn McCormick
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
- Brown Center for the Study of Children at Risk at Women and Infants Hospital
- Rhode Island Consortium for Autism Research and Treatment, East Providence, RI
| | - Blossom Megan
- Psychology Department, Castleton University, Castleton, VT
| | - Dima Amso
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence RI
| | - Stephen J. Sheinkopf
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
- Brown Center for the Study of Children at Risk at Women and Infants Hospital
- Department of Pediatrics, Women and Infants Hospital, Providence, RI
- Rhode Island Consortium for Autism Research and Treatment, East Providence, RI
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25
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McCormick CE, Sheinkopf SJ, Levine TP, LaGasse LL, Tronick E, Lester BL. Diminished respiratory sinus arrhythmia response in infants later diagnosed with autism spectrum disorder. Autism Res 2018; 11:726-731. [DOI: 10.1002/aur.1929] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 12/06/2017] [Accepted: 01/05/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Carolyn E.B. McCormick
- Brown Center for the Study of Children at Risk, Women & Infants Hospital; Providence Rhode Island
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University; Providence Rhode Island
- Department of Human Development and Family Studies; Purdue University; West Lafayette Indiana
| | - Stephen J. Sheinkopf
- Brown Center for the Study of Children at Risk, Women & Infants Hospital; Providence Rhode Island
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University; Providence Rhode Island
- Department of Pediatrics, Warren Alpert Medical School of Brown University; Providence R hode Island
| | - Todd P. Levine
- Brown Center for the Study of Children at Risk, Women & Infants Hospital; Providence Rhode Island
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University; Providence Rhode Island
- Department of Pediatrics, Warren Alpert Medical School of Brown University; Providence R hode Island
| | - Linda L. LaGasse
- Brown Center for the Study of Children at Risk, Women & Infants Hospital; Providence Rhode Island
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University; Providence Rhode Island
- Department of Pediatrics, Warren Alpert Medical School of Brown University; Providence R hode Island
| | - Ed Tronick
- Department of Newborn Medicine, Harvard Medical School; Boston Massachusetts
- Department of Psychology; University of Massachusetts; Boston Massachusetts
| | - Barry L. Lester
- Brown Center for the Study of Children at Risk, Women & Infants Hospital; Providence Rhode Island
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University; Providence Rhode Island
- Department of Pediatrics, Warren Alpert Medical School of Brown University; Providence R hode Island
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Salley B, Sheinkopf SJ, Neal-Beevers AR, Tenenbaum EJ, Miller-Loncar CL, Tronick E, Lagasse LL, Shankaran S, Bada H, Bauer C, Whitaker T, Hammond J, Lester BM. Infants' early visual attention and social engagement as developmental precursors to joint attention. Dev Psychol 2017; 52:1721-1731. [PMID: 27786527 DOI: 10.1037/dev0000205] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study examined infants' early visual attention (at 1 month of age) and social engagement (4 months) as predictors of their later joint attention (12 and 18 months). The sample (n = 325), drawn from the Maternal Lifestyle Study, a longitudinal multicenter project conducted at 4 centers of the National Institute of Child Health and Human Development Neonatal Research Network, included high-risk (cocaine-exposed) and matched noncocaine-exposed infants. Hierarchical regressions revealed that infants' attention orienting at 1 month significantly predicted more frequent initiating joint attention at 12 (but not 18) months of age. Social engagement at 4 months predicted initiating joint attention at 18 months. Results provide the first empirical evidence for the role of visual attention and social engagement behaviors as developmental precursors for later joint attention outcome. (PsycINFO Database Record
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Affiliation(s)
- Brenda Salley
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
| | - Stephen J Sheinkopf
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University
| | - A Rebecca Neal-Beevers
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin
| | - Elena J Tenenbaum
- Brown Center for the Study of Children at Risk, Women and Infants Hospital of Rhode Island
| | | | - Ed Tronick
- Department of Psychology, University of Massachusetts Boston
| | - Linda L Lagasse
- Department of Pediatrics, Warren Alpert Medical School of Brown University
| | - Seetha Shankaran
- Department of Pediatrics, Wayne State University School of Medicine
| | | | - Charles Bauer
- Department of Pediatrics, Miller School of Medicine, University of Miami
| | | | | | - Barry M Lester
- Department of Psychiatry, Warren Alpert Medical School of Brown University
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Abstract
Previous work has demonstrated that social attention is related to early language abilities. We explored whether we can facilitate word learning among children with autism by directing attention to areas of the scene that have been demonstrated as relevant for successful word learning. We tracked eye movements to faces and objects while children watched videos of a woman teaching them new words. Test trials measured participants' recognition of these novel word-object pairings. Results indicate that for children with autism and typically developing children, pointing to the speaker's mouth while labeling a novel object impaired performance, likely because it distracted participants from the target object. In contrast, for children with autism, holding the object close to the speaker's mouth improved performance.
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Affiliation(s)
- Elena J Tenenbaum
- Brown Center for the Study of Children at Risk, Women and Infants Hospital, 101 Dudley Street, Providence, RI, 02905, USA.
- Department of Psychiatry & Human Behavior, Brown University, Providence, RI, USA.
| | - Dima Amso
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, USA
| | - Giulia Righi
- Emma Pendleton Bradley Hospital, East Providence, RI, USA
- Department of Psychiatry & Human Behavior, Brown University, Providence, RI, USA
| | - Stephen J Sheinkopf
- Brown Center for the Study of Children at Risk, Women and Infants Hospital, 101 Dudley Street, Providence, RI, 02905, USA
- Department of Psychiatry & Human Behavior, Brown University, Providence, RI, USA
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Sheinkopf SJ, Tenenbaum EJ, Messinger DS, Miller-Loncar CL, Tronick E, Lagasse LL, Shankaran S, Bada H, Bauer C, Whitaker T, Hammond J, Lester BM. Maternal and infant affect at 4 months predicts performance and verbal IQ at 4 and 7 years in a diverse population. Dev Sci 2016; 20. [PMID: 27774733 DOI: 10.1111/desc.12479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 07/02/2016] [Indexed: 12/18/2022]
Abstract
Using existing longitudinal data from 570 infants in the Maternal Lifestyle Study, we explored the predictive value of maternal and infant affect and maternal vocalizations during 2 minutes of face-to-face interactions at 4 months on IQ scores at 4.5 and 7 years. After controlling for demographic factors, maternal depression, and prenatal drug exposure, maternal positive affect and maternal positive vocalizations emerged as predictors of both verbal and performance IQ at 4.5 and 7 years. Although infant positive affect during the interaction with the mother was not predictive of these outcome measures, infant positive affect towards an examiner predicted verbal but not performance IQ at 4.5 years. These results suggest that maternal positive affect may index emotional engagement in interaction that facilitates both verbal and nonverbal cognitive development, while infant social positive affect is specifically related to the acquisition of verbal reasoning abilities. These findings are significant because they are based on a discrete snapshot of observable behavior in infancy (just 2 minutes of interaction), because they extend the range of maternal behaviors and characteristics known to support positive developmental outcomes, and because they are derived from high-risk infants where prevention efforts may be beneficial. Potential mechanisms for these associations are discussed, as are the clinical implications for identifying dyads most in need of targeted interventions.
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Affiliation(s)
- Stephen J Sheinkopf
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, USA.,Department of Pediatrics, Warren Alpert Medical School of Brown University, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, USA
| | - Elena J Tenenbaum
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, USA
| | | | - Cynthia L Miller-Loncar
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, USA.,Department of Pediatrics, Warren Alpert Medical School of Brown University, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, USA
| | - Ed Tronick
- Department of Psychology, University of Massachusetts Boston, USA.,Harvard Medical School, USA
| | - Linda L Lagasse
- Department of Pediatrics, Warren Alpert Medical School of Brown University, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, USA
| | - Seetha Shankaran
- Department of Pediatrics, Wayne State University School of Medicine, USA
| | | | - Charles Bauer
- Department of Pediatrics, Miller School of Medicine, University of Miami, USA
| | - Toni Whitaker
- Department of Pediatrics, University of Tennessee, USA
| | | | - Barry M Lester
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, USA.,Department of Pediatrics, Warren Alpert Medical School of Brown University, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, USA
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29
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Harrison AJ, Lu Z(L, McLean RL, Sheinkopf SJ. Cognitive and adaptive correlates of an ADOS-derived joint attention composite. Res Autism Spectr Disord 2016; 29-30:66-78. [PMID: 28168003 PMCID: PMC5291343 DOI: 10.1016/j.rasd.2016.07.001] [Citation(s) in RCA: 8] [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: 06/06/2023]
Abstract
Joint attention skills have been shown to predict language outcomes in children with autism spectrum disorder (ASD). Less is known about the relationship between joint attention (JA) abilities in children with ASD and cognitive and adaptive abilities. In the current study, a subset of items from the Autism Diagnostic Observation Schedule (ADOS), designed to quantify JA abilities, were used to investigate social attention among an unusually large cross-sectional sample of children with ASD (n = 1061). An examination of the association between JA and a range of functional correlates (cognitive and adaptive) revealed JA was significantly related to verbal (VIQ) and non-verbal (NVIQ) cognitive ability as well as all domains of adaptive functioning (socialization, communication, and daily living skills). Additional analyses examined the degree to which the relation between adaptive abilities (socialization, communication, and daily living skills) and JA was maintained after taking into account the potentially mediating role of verbal and nonverbal cognitive ability. Results revealed that VIQ fully mediated the relation between JA and adaptive functioning, whereas the relation between these adaptive variables and JA was only partially mediated by NVIQ. Moderation analyses were also conducted to examine how verbal and non-verbal cognitive ability and gender impacted the relation between JA and adaptive functioning. In line with research showing a relation between language and JA, this indicates that while JA is significantly related to functional outcomes, this appears to be mediated specifically through a verbal cognitive pathway.
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Affiliation(s)
| | | | - Rebecca L. McLean
- New England Pediatric Institute of Neurodevelopment, Department of Pediatrics, Memorial Hospital of Rhode Island, Pawtucket, RI, United States
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, United States
| | - Stephen J. Sheinkopf
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, United States
- Women and Infants Hospital, Providence, RI, United States
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Sheinkopf SJ, Righi G, Marsit CJ, Lester BM. Methylation of the Glucocorticoid Receptor (NR3C1) in Placenta Is Associated with Infant Cry Acoustics. Front Behav Neurosci 2016; 10:100. [PMID: 27313516 PMCID: PMC4889592 DOI: 10.3389/fnbeh.2016.00100] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/11/2016] [Indexed: 11/13/2022] Open
Abstract
Epigenetic mechanisms regulating expression of the glucocorticoid receptor gene (NR3C1) promoter may influence behavioral and biological aspects of stress response in human infants. Acoustic features of infant crying are an indicator of neurobehavioral and neurological status not yet investigated in relation to epigenetic mechanisms. We examined NR3C1 methylation in placental tissue from a series of 120 healthy newborn infants in relation to a detailed set of acoustic features extracted from newborn infant cries. We identified significant associations of NR3C1 methylation with energy variation in infants' cries as well as with the presence of very high fundamental frequency in cry utterances. The presence of high fundamental frequency in cry (above 1 kHz) has been linked to poor vocal tract control, poor regulation of stress response, and may be an indicator or poor neurobehavioral integrity. Thus, these results add to evidence linking epigenetic alteration of the NR3C1 gene in the placenta to neurodevelopmental features in infants.
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Affiliation(s)
- Stephen J Sheinkopf
- The Brown Center for the Study of Children at Risk, Women and Infants HospitalProvidence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown UniversityProvidence, RI, USA; Department of Pediatrics, Warren Alpert Medical School of Brown UniversityProvidence, RI, USA
| | - Giulia Righi
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University Providence, RI, USA
| | - Carmen J Marsit
- Section of Biostatistics and Epidemiology, Department of Pharmacology and Toxicology and of Community and Family Medicine, Geisel School of Medicine at Dartmouth Hanover, NH, USA
| | - Barry M Lester
- The Brown Center for the Study of Children at Risk, Women and Infants HospitalProvidence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown UniversityProvidence, RI, USA; Department of Pediatrics, Warren Alpert Medical School of Brown UniversityProvidence, RI, USA
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31
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Tenenbaum EJ, Sobel DM, Sheinkopf SJ, Shah RJ, Malle BF, Morgan JL. Attention to the mouth and gaze following in infancy predict language development. J Child Lang 2015; 42:1173-90. [PMID: 25403090 PMCID: PMC8281329 DOI: 10.1017/s0305000914000725] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We investigated longitudinal relations among gaze following and face scanning in infancy and later language development. At 12 months, infants watched videos of a woman describing an object while their passive viewing was measured with an eye-tracker. We examined the relation between infants' face scanning behavior and their tendency to follow the speaker's attentional shift to the object she was describing. We also collected language outcome measures on the same infants at 18 and 24 months. Attention to the mouth and gaze following at 12 months both predicted later productive vocabulary. The results are discussed in terms of social engagement, which may account for both attentional distribution and language onset. We argue that an infant's inherent interest in engaging with others (in addition to creating more opportunities for communication) leads infants to attend to the most relevant information in a social scene and that this information facilitates language learning.
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Affiliation(s)
- Elena J Tenenbaum
- Brown Center for the Study of Children at Risk at Women and Infants Hospital Providence,RI
| | - David M Sobel
- Department of Cognitive,Linguistic and Psychological Sciences,Brown University,Providence,RI
| | - Stephen J Sheinkopf
- Brown Center for the Study of Children at Risk at Women and Infants Hospital Providence,RI and Department of Psychiatry,Brown University,Providence,RI
| | | | - Bertram F Malle
- Department of Cognitive,Linguistic and Psychological Sciences,Brown University,Providence,RI
| | - James L Morgan
- Department of Cognitive,Linguistic and Psychological Sciences,Brown University,Providence,RI
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Tenenbaum EJ, Sobel DM, Sheinkopf SJ, Malle BF, Morgan JL. Attention to the mouth and gaze following in infancy predict language development - CORRIGENDUM. J Child Lang 2015; 42:1408. [PMID: 26435082 DOI: 10.1017/s0305000915000501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Abstract
Abstract In many lower-income countries, there is a paucity of assessment services for autism spectrum disorders (ASD)., Guidelines will be provided for conducting cross-cultural assessments in the context of limited validated resources in Tanzania. By examining behavioral, social, and adaptive differences we were able to provide differential diagnostic evaluations aligning with best practice standards for 41 children in Tanzania age 2-21 years. We describe the utility of a flexible, behavioral observation instrument, the Childhood Autism Rating Scales, Second Edition (CARS2), to gather diagnostic information in a culturally sensitive manner. We observed that the ASD group was characterized by significantly higher scores on the CARS2, F = 21.09, p < .001, η(2) = .37, than the general delay comparison group. Additional recommendations are provided for making cultural adaptations to current assessment instruments for use in a country without normed instruments, such as Tanzania.
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Akyuz N, Kekatpure MV, Liu J, Sheinkopf SJ, Quinn BT, Lala MD, Kennedy D, Makris N, Lester BM, Kosofsky BE. Structural brain imaging in children and adolescents following prenatal cocaine exposure: preliminary longitudinal findings. Dev Neurosci 2014; 36:316-28. [PMID: 24994509 DOI: 10.1159/000362685] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/05/2014] [Indexed: 01/20/2023] Open
Abstract
The brain morphometry of 21 children, who were followed from birth and underwent structural brain magnetic resonance imaging at 8-10 years, was studied. This cohort included 11 children with prenatal cocaine exposure (CE) and 10 noncocaine-exposed children (NCE). We compared the CE versus NCE groups using FreeSurfer to automatically segment and quantify the volume of individual brain structures. In addition, we created a pediatric atlas specifically for this population and demonstrate the enhanced accuracy of this approach. We found an overall trend towards smaller brain volumes among CE children. The volume differences were significant for cortical gray matter, the thalamus and the putamen. Here, reductions in thalamic and putaminal volumes showed a robust inverse correlation with exposure levels, thus highlighting effects on dopamine-rich brain regions that form key components of brain circuitry known to play important roles in behavior and attention. Interestingly, head circumferences (HCs) at birth as well as at the time of imaging showed a tendency for smaller size among CE children. HCs at the time of imaging correlated well with the cortical volumes for all subjects. In contrast, HCs at birth were predictive of the cortical volume only for the CE group. A subgroup of these subjects (6 CE, 4 NCE) was also scanned at 13-15 years of age. In subjects who were scanned twice, we found that the trend for smaller structures continued into teenage years. We found that the differences in structural volumes between the CE and NCE groups are largely diminished when the HCs are controlled for or matched by study design. Participants in this study were drawn from a unique longitudinal cohort and, while the small sample size precludes strong conclusions regarding the longitudinal findings reported, the results point to reductions in HCs and in specific brain structures that persist through teenage years in children who were exposed to cocaine in utero.
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Affiliation(s)
- Nurunisa Akyuz
- Departments of Neurology and Neuroscience, Weill Cornell Medical College, New York, N.Y., USA
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Tenenbaum EJ, Amso D, Abar B, Sheinkopf SJ. Attention and word learning in autistic, language delayed and typically developing children. Front Psychol 2014; 5:490. [PMID: 24904503 PMCID: PMC4033261 DOI: 10.3389/fpsyg.2014.00490] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/05/2014] [Indexed: 11/13/2022] Open
Abstract
Previous work has demonstrated that patterns of social attention hold predictive value for language development in typically developing infants. The goal of this research was to explore how patterns of attention in autistic, language delayed, and typically developing children relate to early word learning and language abilities. We tracked patterns of eye movements to faces and objects while children watched videos of a woman teaching them a series of new words. Subsequent test trials measured participants' recognition of these novel word-object pairings. Results indicated that greater attention to the speaker's mouth was related to higher scores on standardized measures of language development for autistic and typically developing children (but not for language delayed children). This effect was mediated by age for typically developing, but not autistic children. When effects of age were controlled for, attention to the mouth among language delayed participants was negatively correlated with standardized measures of language learning. Attention to the speaker's mouth and eyes while she was teaching the new words was also predictive of faster recognition of those words among autistic children. These results suggest that language delays among children with autism may be driven in part by aberrant social attention, and that the mechanisms underlying these delays may differ from those in language delayed participants without autism.
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Affiliation(s)
- Elena J. Tenenbaum
- Brown Center for the Study of Children at Risk, Women and Infants HospitalProvidence, RI, USA
| | - Dima Amso
- Department of Cognitive, Linguistic and Psychological Sciences, Brown UniversityProvidence, RI, USA
| | - Beau Abar
- School of Medicine and Dentistry, University of Rochester Medical CenterRochester, NY, USA
| | - Stephen J. Sheinkopf
- Brown Center for the Study of Children at Risk, Women and Infants HospitalProvidence, RI, USA
- Department of Psychiatry and Human Behavior, Brown UniversityProvidence, RI, USA
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Gerber A, Morrow E, Sheinkopf SJ, Anders T. The Rhode Island Consortium for Autism Research and Treatment (RI-CART): a new statewide autism collaborative. R I Med J (2013) 2014; 97:31-4. [PMID: 24791265 PMCID: PMC4134665] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Autism is a neurodevelopmental disorder characterized by core deficits in social interaction, language and repetitive behaviors. The need for services is rising sharply as the number of children identified with autism increases. The Rhode Island Consortium for Autism Research and Treatment (RI-CART) was founded in 2009 with the goal of increasing communication among autism researchers throughout the state and improving treatment for children with autism. RI-CART members have several exciting projects in progress, with its larger aim being the creation of a statewide research registry. A statewide registry would benefit research in Rhode Island and allow for larger collaborations nationally.
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Affiliation(s)
- Alan Gerber
- Clinical Research Assistant at Bradley Hospital
| | - Eric Morrow
- Assistant Professor in Brown University's Departments of Biology, and Psychiatry & Human Behavior. He is also the director of the Developmental Disorders Genetics Research Program at Bradley Hospital
| | - Stephen J Sheinkopf
- Assistant Professor in Brown University's Department of Psychiatry & Human Behavior
| | - Thomas Anders
- Adjunct Professor in Brown University's Department of Psychiatry & Human Behavior. He is also a Senior Research Scientist at Bradley Hospital
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Abstract
We examined the impact of simultaneous bottom-up visual influences and meaningful social stimuli on attention orienting in young children with autism spectrum disorders (ASDs). Relative to typically-developing age and sex matched participants, children with ASDs were more influenced by bottom-up visual scene information regardless of whether social stimuli and bottom-up scene properties were congruent or competing. This initial reliance on bottom-up strategies correlated with severity of social impairment as well as receptive language impairments. These data provide support for the idea that there is enhanced reliance on bottom-up attention strategies in ASDs, and that this may have a negative impact on social and language development.
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Affiliation(s)
- Dima Amso
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, 190 Thayer St., Box 1821, Providence, RI, 02912, USA,
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Affiliation(s)
- Julie A Hofheimer
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Stephen J Sheinkopf
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Lisa T Eyler
- Department of Psychiatry and Autism Center, University of California at San Diego, Mental Illness, Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego, California
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Reggiannini B, Sheinkopf SJ, Silverman HF, Li X, Lester BM. A flexible analysis tool for the quantitative acoustic assessment of infant cry. J Speech Lang Hear Res 2013; 56:1416-28. [PMID: 23785178 PMCID: PMC4956095 DOI: 10.1044/1092-4388(2013/11-0298)] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE In this article, the authors describe and validate the performance of a modern acoustic analyzer specifically designed for infant cry analysis. METHOD Utilizing known algorithms, the authors developed a method to extract acoustic parameters describing infant cries from standard digital audio files. They used a frame rate of 25 ms with a frame advance of 12.5 ms. Cepstral-based acoustic analysis proceeded in 2 phases, computing frame-level data and then organizing and summarizing this information within cry utterances. Using signal detection methods, the authors evaluated the accuracy of the automated system to determine voicing and to detect fundamental frequency (F 0) as compared to voiced segments and pitch periods manually coded from spectrogram displays. RESULTS The system detected F 0 with 88% to 95% accuracy, depending on tolerances set at 10 to 20 Hz. Receiver operating characteristic analyses demonstrated very high accuracy at detecting voicing characteristics in the cry samples. CONCLUSIONS This article describes an automated infant cry analyzer with high accuracy to detect important acoustic features of cry. A unique and important aspect of this work is the rigorous testing of the system's accuracy as compared to ground-truth manual coding. The resulting system has implications for basic and applied research on infant cry development.
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Liu J, Lester BM, Neyzi N, Sheinkopf SJ, Gracia L, Kekatpure M, Kosofsky BE. Regional brain morphometry and impulsivity in adolescents following prenatal exposure to cocaine and tobacco. JAMA Pediatr 2013; 167:348-54. [PMID: 23400239 PMCID: PMC4467165 DOI: 10.1001/jamapediatrics.2013.550] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Animal studies have suggested that prenatal cocaine exposure (PCE) deleteriously influences the developing nervous system, in part attributable to its site of action in blocking the function of monoamine reuptake transporters, increasing synaptic levels of serotonin and dopamine. OBJECTIVE To examine the brain morphologic features and associated impulsive behaviors in adolescents following prenatal exposure to cocaine and/or tobacco. DESIGN Magnetic resonance imaging data and behavioral measures were collected from adolescents followed up longitudinally in the Maternal Lifestyle Study. SETTING A hospital-based research center. PARTICIPANTS A total of 40 adolescent participants aged 13 to 15 years were recruited, 20 without PCE and 20 with PCE; a subset of each group additionally had tobacco exposure. Participants were selected and matched based on head circumference at birth, gestational age, maternal alcohol use, age, sex, race/ethnicity, IQ, family poverty, and socioeconomic status. MAIN OUTCOME MEASURES Subcortical volumetric measures of the thalamus, caudate, putamen, pallidum, hippocampus, amygdala, and nucleus accumbens; cortical thickness measures of the dorsolateral prefrontal cortex and ventral medial prefrontal cortex; and impulsivity assessed by Conners' Continuous Performance Test and the Sensation Seeking Scale for Children. RESULTS After controlling for covariates, cortical thickness of the right dorsolateral prefrontal cortex was significantly thinner in adolescents following PCE (P = .03), whereas the pallidum volume was smaller in adolescents following prenatal tobacco exposure (P = .03). Impulsivity was correlated with thalamic volume following either PCE (P = .05) or prenatal tobacco exposure (P = .04). CONCLUSIONS AND RELEVANCE Prenatal cocaine or tobacco exposure can differentially affect structural brain maturation during adolescence and underlie enhanced susceptibility to impulsivity. Additional studies with larger sample sizes are warranted.
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Affiliation(s)
- Jie Liu
- Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA
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Bagner DM, Graziano PA, Jaccard J, Sheinkopf SJ, Vohr BR, Lester BM. An initial investigation of baseline respiratory sinus arrhythmia as a moderator of treatment outcome for young children born premature with externalizing behavior problems. Behav Ther 2012; 43:652-65. [PMID: 22697452 PMCID: PMC3475510 DOI: 10.1016/j.beth.2011.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 12/19/2011] [Accepted: 12/21/2011] [Indexed: 10/14/2022]
Abstract
The aim of the current study was to examine the moderating effect of baseline respiratory sinus arrhythmia (RSA) on Parent-Child Interaction Therapy (PCIT), a behavioral parent-training intervention, for young children born premature. In this pilot randomized controlled trial, 28 young children (mean age of 37.79 months), who were born <37 weeks gestation and presented with elevated externalizing behavior problems, were randomly assigned to an immediate treatment or waitlist control group. RSA, which provides an approximate marker of individual differences in cardiac vagal tone, was measured during a baseline period. Past research has generally shown that higher levels of baseline RSA correlate with various positive psychological states (e.g., empathy, sustained attention), whereas lower levels of baseline RSA correlate with less optimal psychological states (e.g., higher externalizing behavior problems). Results indicated that baseline RSA significantly interacted with treatment condition in predicting changes in child disruptive behavior. Specifically, low levels of baseline RSA were associated with greater improvements in child disruptive behavior following PCIT. While acknowledging the caveats of measuring and interpreting RSA and the need to include a sympathetic-linked cardiac measure in future research, these findings provide preliminary evidence that children with lower capacity for emotion regulation receive even greater treatment gains. Future research should also examine the moderating effect of RSA in larger samples and explore the potential mediating role of RSA on behavioral parenting interventions.
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Sheinkopf SJ, Iverson JM, Rinaldi ML, Lester BM. Atypical cry acoustics in 6-month-old infants at risk for autism spectrum disorder. Autism Res 2012; 5:331-9. [PMID: 22890558 DOI: 10.1002/aur.1244] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 06/25/2012] [Indexed: 01/30/2023]
Abstract
This study examined differences in acoustic characteristics of infant cries in a sample of babies at risk for autism and a low-risk comparison group. Cry samples derived from vocal recordings of 6-month-old infants at risk for autism spectrum disorder (ASD; n = 21) and low-risk infants (n = 18) were subjected to acoustic analyses using analysis software designed for this purpose. Cries were categorized as either pain-related or non-pain-related based on videotape coding. At-risk infants produced pain-related cries with higher and more variable fundamental frequency (F (0) ) than low-risk infants. At-risk infants later classified with ASD at 36 months had among the highest F (0) values for both types of cries and produced cries that were more poorly phonated than those of nonautistic infants, reflecting cries that were less likely to be produced in a voiced mode. These results provide preliminary evidence that disruptions in cry acoustics may be part of an atypical vocal signature of autism in early life.
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Affiliation(s)
- Stephen J Sheinkopf
- Departments of Psychiatry & Human Behavior and Pediatrics, Center for the Study of Children at Risk, Brown Alpert Medical School, Women & Infants Hospital, Providence, Rhode Island 02905, USA.
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Graziano PA, Bagner DM, Sheinkopf SJ, Vohr BR, Lester BM. Evidence-based intervention for young children born premature: preliminary evidence for associated changes in physiological regulation. Infant Behav Dev 2012; 35:417-28. [PMID: 22721742 PMCID: PMC3409342 DOI: 10.1016/j.infbeh.2012.04.001] [Citation(s) in RCA: 16] [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: 07/11/2011] [Revised: 12/16/2011] [Accepted: 04/04/2012] [Indexed: 11/16/2022]
Abstract
The current study examined whether changes in maternal behaviors following an evidence-based treatment-Parent-Child Interaction Therapy (PCIT)-was associated with improvements in cardiac vagal regulation in young children born premature. Participants included 28 young children (mean age = 37.79 months) that were born premature and presented with elevated externalizing behavior problems. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (withdrawal or suppression) to a clean-up task were derived pre and post-treatment. Results indicated that an increase in behaviors mothers are taught to use during treatment (i.e., do skills-praise, reflection, and behavioral descriptions) was associated with an improvement in children's post-treatment RSA suppression levels. The current study illustrates the important role of caregiver behavior in promoting physiological regulation in children born premature.
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Affiliation(s)
- Paulo A Graziano
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL 33199, United States.
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Levine TP, Sheinkopf SJ, Pescosolido M, Rodino A, Elia G, Lester B. Physiologic Arousal to Social Stress in Children with Autism Spectrum Disorders: A Pilot Study. Res Autism Spectr Disord 2012; 6:177-183. [PMID: 22081773 PMCID: PMC3212393 DOI: 10.1016/j.rasd.2011.04.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Little is known about arousal to socially stressful situations in children with Autism Spectrum Disorders. This preliminary study investigates physiologic arousal in children with high functioning autism (HFA, n=19) compared to a comparison group (n=11) before, during, and after the Trier Social Stress Test. The HFA group was more likely to have a decrease in salivary cortisol following the stressor, while the comparison group was more likely to have an increase (p=.02). However, there was no difference in electrodermal activity, a measure of sympathetic arousal, or vagal tone, a measure of parasympathetic activity, between groups. These findings implicate a differential neuroendocrine response to social stress in children with HFA despite similar sympathetic and parasympathetic responses during a stressor. Further studies are required to substantiate this finding.
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Affiliation(s)
- Todd P. Levine
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Brown Center for the Study of Children at Risk, 101 Dudley Street, Providence, Rhode Island, 02905, United States
| | - Stephen J. Sheinkopf
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Brown Center for the Study of Children at Risk, 101 Dudley Street, Providence, Rhode Island, 02905, United States
| | - Matthew Pescosolido
- Brown Center for the Study of Children at Risk, 101 Dudley Street, Providence, Rhode Island, 02905, United States
| | - Alison Rodino
- Brown Center for the Study of Children at Risk, 101 Dudley Street, Providence, Rhode Island, 02905, United States
| | - Gregory Elia
- Brown Center for the Study of Children at Risk, 101 Dudley Street, Providence, Rhode Island, 02905, United States
| | - Barry Lester
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Brown Center for the Study of Children at Risk, 101 Dudley Street, Providence, Rhode Island, 02905, United States
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Liu J, Cohen RA, Gongvatana A, Sheinkopf SJ, Lester BM. Impact of prenatal exposure to cocaine and tobacco on diffusion tensor imaging and sensation seeking in adolescents. J Pediatr 2011; 159:771-5. [PMID: 21723565 PMCID: PMC3420810 DOI: 10.1016/j.jpeds.2011.05.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [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: 12/17/2010] [Revised: 03/24/2011] [Accepted: 05/13/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To study white matter integrity with diffusion tensor imaging in adolescents with prenatal cocaine exposure, tobacco exposure, or both. STUDY DESIGN Subjects included 20 adolescents with prenatal cocaine exposure (15 with tobacco exposure) and 20 non-cocaine-exposed subjects (8 with tobacco exposure). Diffusion tensor imaging measures were assessed in 5 subregions of the corpus callosum. The Sensation Seeking Scale for Children was administered to evaluate behavioral inhibition. RESULTS No significant differences were found between the cocaine-exposed and non-cocaine-exposed groups in each subregion of the corpus callosum on measures of fractional anisotropy (FA) and mean diffusivity, although the cocaine-exposed group showed a trend (P = .06) toward higher FA in projections to the supplementary motor area and premotor cortex. Prenatal tobacco exposure was associated with decreased FA in the supplementary motor area and premotor cortex projections after adjustment for relevant co-variates (P = .03). Decreased FA was related to more sensation seeking in the adolescents who were prenatally exposed to tobacco. CONCLUSION Prenatal tobacco exposure could affect white matter integrity, which is related to sensation seeking in adolescents. Developmental neurotoxins might have differential influences on white matter maturation in adolescence.
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Affiliation(s)
- Jie Liu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Bagner DM, Sheinkopf SJ, Vohr BR, Lester BM. A preliminary study of cortisol reactivity and behavior problems in young children born premature. Dev Psychobiol 2011; 52:574-82. [PMID: 20806330 DOI: 10.1002/dev.20464] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The purpose of the present study was to examine the relation between cortisol reactivity and comorbid internalizing and externalizing behavior problems among children born premature. Children between the ages of 18 and 60 months who were born <37 weeks gestation and presented with clinically significant externalizing behavior problems were included. Children were categorized based on those who mounted a cortisol response to a stressor and those who did not mount a cortisol response. Children demonstrating the cortisol response were reported to have more problems with attention, emotional reactivity, anxiety, and depression based on maternal report and displayed higher rates of negative verbalizations during a mother-child interaction than children without a cortisol response. These results extend the findings of the relation between cortisol reactivity and comorbid internalizing and externalizing behavior problems to a sample of children born premature.
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Affiliation(s)
- Daniel M Bagner
- Department of Psychology, Florida International University, 11200 S.W. 8th St., Miami, Florida 33199, USA.
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Bagner DM, Sheinkopf SJ, Miller-Loncar CL, Vohr BR, Hinckley M, Eyberg SM, Lester BM. Parent-Child Interaction Therapy for Children Born Premature: A Case Study and Illustration of Vagal Tone as a Physiological Measure of Treatment Outcome. Cogn Behav Pract 2009; 16:468-477. [PMID: 20428470 DOI: 10.1016/j.cbpra.2009.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Evidence-based psychosocial interventions for externalizing behavior problems in children born premature have not been reported in the literature. This single-case study describes Parent-Child Interaction Therapy (PCIT) with a 23-month-old child born at 29 weeks gestation weighing 1,020 grams, who presented with significant externalizing behavior problems. Treatment outcome was assessed using standard measures of maternal and child functioning and observational measures of the parent-child interaction, as well as a physiological measure of heart rate variability (i.e., vagal tone) used to assess parasympathetic control in the child. Maternal reports of child behavior problems and their own stress and depressive symptoms decreased after treatment. Behavioral observations demonstrated improved parenting practices and child compliance, and vagal tone showed comparable increases as well. Results suggest that PCIT is a promising psychosocial intervention for children born premature with externalizing behavior problems, and that vagal tone may be a useful measure of treatment outcome.
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Affiliation(s)
- Daniel M Bagner
- Brown Center for the Study of Children at Risk, Women & Infants' Hospital, Warren Alpert Medical School of Brown University, 101 Dudley St., Providence, RI 02905
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Sheinkopf SJ, Lester BM, Sanes JN, Eliassen JC, Hutchison ER, Seifer R, Lagasse LL, Durston S, Casey BJ. Functional MRI and response inhibition in children exposed to cocaine in utero. Preliminary findings. Dev Neurosci 2009; 31:159-66. [PMID: 19372696 DOI: 10.1159/000207503] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 10/20/2008] [Indexed: 11/19/2022] Open
Abstract
This study investigated the potential long-term effects of cocaine exposure on brain functioning using fMRI in school-aged children. The sample included 12 children with prenatal cocaine exposure and 12 non-exposed children (8-9 years old). Groups did not differ on IQ, socioeconomic status, or perinatal risk factors. A response inhibition task was administered during an fMRI scan using a 1.5-T MRI system. Task performance did not differentiate groups, but groups were differentiated by patterns of task-related brain activity. Cocaine-exposed children showed greater activation in the right inferior frontal cortex and caudate during response inhibition, whereas non-exposed children showed greater activations in temporal and occipital regions. These preliminary findings suggest that prenatal cocaine may affect the development of brain systems involved in the regulation of attention and response inhibition.
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Affiliation(s)
- Stephen J Sheinkopf
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA.
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Bagner DM, Sheinkopf SJ, Miller-Loncar C, LaGasse LL, Lester BM, Liu J, Bauer CR, Shankaran S, Bada H, Das A. The effect of parenting stress on child behavior problems in high-risk children with prenatal drug exposure. Child Psychiatry Hum Dev 2009; 40:73-84. [PMID: 18626768 PMCID: PMC2861499 DOI: 10.1007/s10578-008-0109-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 06/23/2008] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the relationship between early parenting stress and later child behavior in a high-risk sample and measure the effect of drug exposure on the relationship between parenting stress and child behavior. METHODS A subset of child-caregiver dyads (n=607) were selected from the Maternal Lifestyle Study (MLS), which is a large sample of children (n=1,388) with prenatal cocaine exposure and a comparison sample unexposed to cocaine. Of the 607 dyads, 221 were prenatally exposed to cocaine and 386 were unexposed to cocaine. Selection was based on the presence of a stable caregiver at 4 and 36 months with no evidence of change in caregiver between those time points. RESULTS Parenting stress at 4 months significantly predicted child externalizing behavior at 36 months. These relations were unaffected by cocaine exposure suggesting the relationship between parenting stress and behavioral outcome exists for high-risk children regardless of drug exposure history. CONCLUSIONS These results extend the findings of the relationship between parenting stress and child behavior to a sample of high-risk children with prenatal drug exposure. Implications for outcome and treatment are discussed.
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Affiliation(s)
- Daniel M. Bagner
- Brown Center for the Study of Children at Risk, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Stephen J. Sheinkopf
- Brown Center for the Study of Children at Risk, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Cynthia Miller-Loncar
- Brown Center for the Study of Children at Risk, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Linda L. LaGasse
- Brown Center for the Study of Children at Risk, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Barry M. Lester
- Brown Center for the Study of Children at Risk, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Jing Liu
- Brown Center for the Study of Children at Risk, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, RI
| | | | | | | | - Abhik Das
- Research Triangle Institute, Rockville, Maryland
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Sheinkopf SJ, Lagasse LL, Lester BM, Liu J, Seifer R, Bauer CR, Shankaran S, Bada H, Das A. Vagal tone as a resilience factor in children with prenatal cocaine exposure. Dev Psychopathol 2008; 19:649-73. [PMID: 17705897 DOI: 10.1017/s0954579407000338] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Studies have investigated the potential effects of prenatal cocaine exposure (CE) on children's development. However, few studies have examined predictors of resilient outcomes in this population. We examined vagal tone (VT) as a resilience factor in prenatal CE. Utilizing data from the Maternal Lifestyle Study, a cumulative risk index was derived for children with and without prenatal CE. Presence of CE and other prenatal drugs was summed with postnatal risks in infancy to yield a 15-item risk index. Preschool cognitive outcomes, problem behaviors, and adaptive behaviors were measured. VT was assessed during an infant exam at 1 month and toy exploration at 36 months. We included children with complete physiologic data (217 CE, 333 non-CE). Children were classified as having consistently high, consistently low, or fluctuating VT at 1 and 36 months. Children were also classified as high versus low risk. High-risk children had lower IQ scores, more problem behaviors, and lower ratings of adaptive behaviors than low-risk children. A significant risk by VT-stability interaction indicated that for high-risk children, those with stable low VT had higher ratings of adaptive behaviors at 36 months. This is consistent with theory linking reduced VT during tasks to adaptive regulation and indicates that such regulatory functioning may serve as a protective factor in prenatal CE.
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