1. Azad G, Reisinger E, Xie M, Mandell DS. {{Parent and Teacher Concordance on the Social Responsiveness Scale for Children with Autism}}. {School Ment Health};2016 (Sep);8(3):368-376.
There are inconsistent findings regarding parent and teacher agreement on behavioral ratings of their children with autism. One possible reason for this inconsistency is that studies have not taken autism severity into account. This study examined parent and teacher concordance of social behavior based on symptom severity for children with autism. Participants were 123 parent-teacher dyads who completed the Social Responsiveness Scale. Symptom severity was assessed using the Autism Diagnostic Observation Schedule (ADOS). Results indicated that parent and teacher ratings were statistically significantly correlated at the beginning and end of the academic year, but only for severely affected children. Teacher report of social deficits was correlated with symptom severity as measured by the ADOS; parent report was not. These findings have implications for improving assessment procedures and parent-teacher collaboration.
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2. Cashin A, Buckley T, Trollor JN, Lennox N. {{A scoping review of what is known of the physical health of adults with autism spectrum disorder}}. {J Intellect Disabil};2016 (Sep 13)
Little research has been carried out on the physical health of people with autism spectrum disorder (ASD). From the studies conducted with both children and adults, few studies have moved beyond retrospective record analysis and survey and conducted health assessment. The majority of the studies are from the United States of America with a small number conducted in Europe. A scoping review was conducted to determine what is known of the physical health of adults with ASD and to identify research gaps. In addition to studies of adults, this review includes studies of children to determine possible health trajectories. From the findings, it can be stated with confidence that people with ASD have a high rate of comorbidity and increased risk for chronic disease.
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3. Gossett A, Sansone S, Schneider A, Johnston C, Hagerman R, Tassone F, Rivera SM, Seritan AL, Hessl D. {{Psychiatric disorders among women with the fragile X premutation without children affected by fragile X syndrome}}. {Am J Med Genet B Neuropsychiatr Genet};2016 (Sep 12)
Several studies have demonstrated increased rates of anxiety and depressive disorders among female carriers of the fragile X premutation. However, the majority of these studies focused on mothers of children with fragile X syndrome, who experience higher rates of parenting stress that may contribute to the emergence of these disorders. The present study compared psychiatric symptom presentation (utilizing measures of current symptoms and lifetime DSM-IV Axis I disorders) in 24 female carriers without affected children (mean age = 32.1 years) to 26 non-carrier women from the community (mean age = 30.5 years). We also examined the association between CGG repeat size (adjusted for X activation ratio) and mRNA, with severity of psychiatric symptoms. Women with the premutation reported significantly elevated symptoms of anxiety, depression, interpersonal sensitivity, obsessive-compulsiveness, and somatization relative to controls during the past week. Carriers had significantly higher rates of lifetime social phobia (42.3%) compared to controls (12.5%); however, this comparison did not remain significant after multiple comparison adjustment. Rates of other psychiatric disorders were not significantly elevated relative to controls, though it should be noted that lifetime rates among controls were much higher than previously published population estimates. Although the sample is relatively small, the study of this unique cohort suggests the premutation confers risk for mood and anxiety disorders independent of the stress of parenting children with FXS. Screening for psychiatric disorders in women with the premutation, even before they become parents, is important and highly encouraged. (c) 2016 Wiley Periodicals, Inc.
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4. Haebig E, Sterling A, Hoover J. {{Examining the Language Phenotype in Children With Typical Development, Specific Language Impairment, and Fragile X Syndrome}}. {J Speech Lang Hear Res};2016 (Sep 8):1-13.
Purpose: One aspect of morphosyntax, finiteness marking, was compared in children with fragile X syndrome (FXS), specific language impairment (SLI), and typical development matched on mean length of utterance (MLU). Method: Nineteen children with typical development (mean age = 3.3 years), 20 children with SLI (mean age = 4.9 years), and 17 boys with FXS (mean age = 11.9 years) completed the Test of Early Grammatical Impairment (TEGI; Rice & Wexler, 2001), and other cognitive and language assessments. Quantitative comparisons on finiteness marking and qualitative comparisons of unscorable (i.e., nontarget) TEGI responses were conducted. Results: Children with typical development and FXS performed better on finiteness marking than children with SLI. Although unscorable responses were infrequent, boys with FXS produced more unscorable responses than children with typical development and SLI. Conclusions: Although boys with FXS have language deficits, they performed similarly to MLU-matched typically developing children on finiteness marking. This language profile differs from children with SLI, who present with a delay-within-a-delay profile with finiteness marking delays that exceed delays in MLU. Unscorable responses produced by the boys with FXS may reflect pragmatic deficits, which are prominent in this population. Assessment procedures should be carefully considered when examining language in boys with FXS.
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5. Hannah LA, Stagg SD. {{Experiences of Sex Education and Sexual Awareness in Young Adults with Autism Spectrum Disorder}}. {J Autism Dev Disord};2016 (Sep 13)
The research investigated feelings towards sex education and sexual awareness in young adults with autism spectrum disorder (ASD). Data were generated from the sexual knowledge, experiences, feelings and needs questionnaire (McCabe et al. 1999), the sexual awareness questionnaire (Snell et al. 1991) and semi-structured interviews. Twenty typically developing and 20 ASD individuals participated. Feelings toward sex education did not differ between the groups, but the groups differed significantly on measures of sexual awareness. Negative experiences of sex education and issues of vulnerability, social anxiety, and confused sexuality were prominent features of the qualitative interviews. This report suggest that mainstream sex and relationship education is not sufficient for people with ASD, specific methods and curricular are necessary to match their needs.
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6. Jaber M. {{[The cerebellum as a major player in motor disturbances related to Autistic Syndrome Disorders]}}. {Encephale};2016 (Sep 8)
SCIENTIFIC BACKGROUND: Autism spectrum disorders (ASD) are neurodevelopmental disorders associated with disturbances in communication, social interactions, cognition and affect. ASD are also accompanied by complex movement disorders, including ataxia. A special focus of recent research in this area is made on the striatum and the cerebellum, two structures known not only to control movement but also to be involved in cognitive functions such as memory and language. Dysfunction within the motor system may be associated with abnormal movements in ASD that are translated into ataxia, abnormal pattern of righting, gait sequencing, development of walking, and hand positioning. This line of study may generate new knowledge and understanding of motor symptoms associated with ASD and aims to deliver fresh perspectives for early diagnosis and therapeutic strategies against ASD. AIMS OF THE REVIEW: Despite the relative paucity of research in this area (compared to the social, linguistic, and behavioural disturbances in ASD), there is evidence that the frontostriatal motor system and/or the cerebellar motor systems may be the site of dysfunction in ASD. Indeed, the cerebellum seems to be essential in the development of basic social capabilities, communication, repetitive/restrictive behaviors, and motor and cognitive behaviors that are all impaired in ASD. Cerebellar neuropathology including cerebellar hypoplasia and reduced cerebellar Purkinje cell numbers are the most consistent neuropathologies linked to ASD. The functional state of the cerebellum and its impact on brain function in ASD is the focus of this review. This review starts by recapitulating historical findings pointing towards an implication of the cerebellum, and to a lesser extent the basal ganglia structures, in TSA. We then detail the structure/function of the cerebellum at the regional and cellular levels before describing human and animal findings indicating a role of the cerebellum and basal ganglia in ASD. HUMAN AND ANIMAL FINDINGS: Several studies have attempted to identify the nature of the motor system dysfunction in ASD, and it became apparent that the motor fronto-striatal and cerebellar systems are major sites of dysfunction in this psychiatric illness. Anomalies in these structures have been revealed both at the anatomical and functional levels in human patients as well as in animal models. These models are obtained by manipulation of genes that are often implicated in glutamate transmission, by lesions of brain structures among which the cerebellum, by pharmacological treatment with drugs such as the Valproate or by maternal infections with bacterial membrane extracts of double stranded RNA mimicking a viral infection. CONCLUSION: The « cognitive approach » has dominated ASD research for three decades and led to the design of interventional strategies, which have yielded satisfactory results. Nevertheless, new approaches and alternative hypotheses on the aetiology and diagnosis of ASD are needed. Research focused on motor rather than psychiatric symptoms may have a greater potential to elucidate the neurobiological basis of ASD.
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7. Jobski K, Hofer J, Hoffmann F, Bachmann C. {{Use of psychotropic drugs in patients with autism spectrum disorders: a systematic review}}. {Acta Psychiatr Scand};2016 (Sep 13)
OBJECTIVE: The objective of this review was to examine prevalence and patterns of psychopharmacotherapy in individuals with autism spectrum disorder (ASD). METHOD: A systematic literature search in PubMed, CINAHL, and PsycINFO was performed, including articles published up to November 18, 2015. RESULTS: A total of 47 studies (data collection: 1976-2012), encompassing >300 000 individuals with ASD, were included. The prevalence of psychopharmacotherapy ranged from 2.7% to 80% (median (overall): 45.7%; median (children): 41.9%; median (adults): 61.5%), with psychotropic polypharmacy occurring in 5.4-54% (median: 23.0%). Regarding drug classes, antipsychotics were most frequently used, followed by attention-deficit/hyperactivity disorder (ADHD) medication and antidepressants. Both older age and psychiatric comorbidity were associated with higher prevalences of psychopharmacotherapy and psychotropic polypharmacy. There were no time trends in psychopharmacotherapy prevalence observable. CONCLUSION: Despite a lack of pharmacological treatment options for ASD core symptoms, the prevalence of psychopharmacotherapy and polypharmacy in ASD patients is considerable, which is probably due to the treatment of non-core ASD symptoms and psychiatric comorbidities. While there is some evidence for the use of antipsychotics and ADHD medication for these indications, the use of antidepressants should be limited to selected cases.
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8. Johansen A, Rosti RO, Musaev D, Sticca E, Harripaul R, Zaki M, Caglayan AO, Azam M, Sultan T, Froukh T, Reis A, Popp B, Ahmed I, John P, Ayub M, Ben-Omran T, Vincent JB, Gleeson JG, Abou Jamra R. {{Mutations in MBOAT7, Encoding Lysophosphatidylinositol Acyltransferase I, Lead to Intellectual Disability Accompanied by Epilepsy and Autistic Features}}. {Am J Hum Genet};2016 (Sep 7)
The risk of epilepsy among individuals with intellectual disability (ID) is approximately ten times that of the general population. From a cohort of >5,000 families affected by neurodevelopmental disorders, we identified six consanguineous families harboring homozygous inactivating variants in MBOAT7, encoding lysophosphatidylinositol acyltransferase (LPIAT1). Subjects presented with ID frequently accompanied by epilepsy and autistic features. LPIAT1 is a membrane-bound phospholipid-remodeling enzyme that transfers arachidonic acid (AA) to lysophosphatidylinositol to produce AA-containing phosphatidylinositol. This study suggests a role for AA-containing phosphatidylinositols in the development of ID accompanied by epilepsy and autistic features.
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9. Juczewski K, von Richthofen H, Bagni C, Celikel T, Fisone G, Krieger P. {{Somatosensory map expansion and altered processing of tactile inputs in a mouse model of fragile X syndrome}}. {Neurobiol Dis};2016 (Sep 8)
Fragile X syndrome (FXS) is a common inherited form of intellectual disability caused by the absence or reduction of the fragile X mental retardation protein (FMRP) encoded by the FMR1 gene. In humans, one symptom of FXS is hypersensitivity to sensory stimuli, including touch. We used a mouse model of FXS (Fmr1 KO) to study sensory processing of tactile information conveyed via the whisker system. In vivo electrophysiological recordings in somatosensory barrel cortex showed layer-specific broadening of the receptive fields at the level of layer 2/3 but not layer 4, in response to whisker stimulation. Furthermore, the encoding of tactile stimuli at different frequencies was severely affected in layer 2/3. The behavioral effect of this broadening of the receptive fields was tested in the gap-crossing task, a whisker-dependent behavioral paradigm. In this task the Fmr1 KO mice showed differences in the number of whisker contacts with platforms, decrease in the whisker sampling duration and reduction in the whisker touch-time while performing the task. We propose that the increased excitability in the somatosensory barrel cortex upon whisker stimulation may contribute to changes in the whisking strategy as well as to other observed behavioral phenotypes related to tactile processing in Fmr1 KO mice.
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10. Kuizenga-Wessel S, Di Lorenzo C, Nicholson LM, Butter EM, Ratliff-Schaub KL, Benninga MA, Williams KC. {{Screening for autism identifies behavioral disorders in children functional defecation disorders}}. {Eur J Pediatr};2016 (Sep 13)
This study prospectively assessed whether positive screening surveys for autism spectrum disorders (ASDs) in children with functional defecation disorders (FDDs) accurately identify ASD. Parents of children (4-12 years) who met Rome III criteria for functional constipation (FC), FC with fecal incontinence (FI) and functional nonretentive FI (FNRFI) completed two ASD screening surveys. Children with positive screens were referred for psychological evaluation, and a year later, follow-up surveys were conducted. Of the 97 study participants, 30.9 % were diagnosed with FC, 62.9 % with FC with FI, and 6.2 % with FNRFI. ASD surveys were positive for 27 children (27.8 %). New DSM diagnoses were made in 10 out of the 15 children that completed further evaluation. Two (2.1 %) met criteria for ASD, and 12 (12.4 %) met criteria for other behavioral disorders. Average SRS and SCQ-L scores were higher in subjects with FC with FI as compared to FC alone and in those who reported no improvement versus those who reported improvement 1 year later. CONCLUSION: While positive ASD screening surveys did not correctly identify ASD in the majority, it did help to identify other unrecognized behavioral disorders in children with FDD. High screening scores were more common in children with FC with FI and in children with poorer responses to current medical treatments. WHAT IS KNOWN: *A prior study found that 29 % of children with FDD scored positive on ASD screening questionnaires. *Whether positive screens correctly identify ASD in children with FDD is unknown. What is New: *This study shows that positive ASD screens do not correctly identify ASD in children with FDD. However, the use of ASD screening questionnaires can identify previously unrecognized and untreated behavioral/developmental disorders in children with FDD. *High screening scores are more common in children with FC with FI and in children with poorer responses to current medical treatments.
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11. Locke J, Williams J, Shih W, Kasari C. {{Characteristics of socially successful elementary school-aged children with autism}}. {J Child Psychol Psychiatry};2016 (Sep 13)
BACKGROUND: The extant literature demonstrates that children with autism spectrum disorder (ASD) often have difficulty interacting and socially connecting with typically developing classmates. However, some children with ASD have social outcomes that are consistent with their typically developing counterparts. Little is known about this subgroup of children with ASD. This study examined the stable (unlikely to change) and malleable (changeable) characteristics of socially successful children with ASD. METHODS: This study used baseline data from three intervention studies performed in public schools in the Southwestern United States. A total of 148 elementary-aged children with ASD in 130 classrooms in 47 public schools participated. Measures of playground peer engagement and social network salience (inclusion in informal peer groups) were obtained. RESULTS: The results demonstrated that a number of malleable factors significantly predicted playground peer engagement (class size, autism symptom severity, peer connections) and social network salience (autism symptom severity, peer connections, received friendships). In addition, age was the only stable factor that significantly predicted social network salience. Interestingly, two malleable (i.e., peer connections and received friendships) and no stable factors (i.e., age, IQ, sex) predicted overall social success (e.g., high playground peer engagement and social network salience) in children with ASD. CONCLUSIONS: School-based interventions should address malleable factors such as the number of peer connections and received friendships that predict the best social outcomes for children with ASD.
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12. Lonnqvist L, Loukusa S, Hurtig T, Makinen L, Siipo A, Vayrynen E, Palo P, Laukka S, Mammela L, Mattila ML, Ebeling H. {{How Young Adults with Autism Spectrum Disorder Watch and Interpret Pragmatically Complex Scenes}}. {Q J Exp Psychol (Hove)};2016 (Sep 12):1-41.
The aim of the current study was to investigate subtle characteristics of social perception and interpretation in high-functioning individuals with autism spectrum disorders (ASDs), and to study the relation between watching and interpreting. As a novelty, we used an approach that combined moment-by-moment eye tracking and verbal assessment. Sixteen young adults with ASD and 16 neurotypical control participants watched a video depicting a complex communication situation while their eye movements were tracked. The participants also completed a verbal task with questions related to the pragmatic content of the video. We compared verbal task scores and eye movements between groups, and assessed correlations between task performance and eye movements. Individuals with ASD had more difficulty than the controls in interpreting the video and during two short moments there were significant group differences in eye movements. Additionally, we found significant correlations between verbal task scores and moment-level eye movement in the ASD group, but not among the controls. We concluded that participants with ASD had slight difficulties in understanding the pragmatic content of the video stimulus and attending to social cues, and that the connection between pragmatic understanding and eye movements was more pronounced for participants with ASD than for neurotypical participants. PQJE_1233988_Supplemental_Material.docx.
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13. Mah JW, Tsang P. {{Visual Schedule System in Dental Care for Patients with Autism: A Pilot Study}}. {J Clin Pediatr Dent};2016;40(5):393-399.
OBJECTIVES: A pilot study to test whether a visual schedule system using picture communication symbols can help children with autism have successful routine dental cleaning visits. STUDY DESIGN: 14 boys with autism between three- to eight-years-old presented to the dental clinic for four weekly consecutive dental appointments. Patients were randomly assigned to either the control group who received the tell-show-do method (i.e., standard of care), or the test group who received the tell-show-do method plus the visual schedule system. RESULTS: Patients in the test group completed an average of 1.38 more steps, at 35.52 seconds per step faster, and with 18.7% lower levels of behavioral distress than those in the control group. CONCLUSION: The use of a visual schedule system, along with repeated weekly visits, showed some promise in helping children with autism successfully complete more steps, progress at a quicker rate, and exhibit lower levels of behavioral distress within a dental appointment, compared to a traditional tell-show-do approach.
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14. Reed P, Picton L, Grainger N, Osborne LA. {{Impact of Diagnostic Practices on the Self-Reported Health of Mothers of Recently Diagnosed Children with ASD}}. {Int J Environ Res Public Health};2016;13(9)
OBJECTIVES: Obtaining a diagnosis of an Autism Spectrum Disorder (ASD) for a child is a pivotal point in developing the treatment plan for the child but can also be regarded as highly stressful by parents. The current study examined the impact of different aspects of the diagnosis process on the self-reported mental health of mothers of children undergoing a diagnosis for ASD in a cross-sectional cohort design. METHODS: One-hundred-fifty-eight mothers of consequently diagnosed children with ASD participated. The severity of the children’s ASD and their intellectual functioning was assessed within twelve months of the diagnosis, and the mothers completed a psychometric assessment battery including the Hospital Anxiety and Depression Scale, General Health Questionnaire, and Questionnaire on Resources and Stress. RESULTS: The actual time from first reporting a problem to obtaining a diagnosis, and the speed of the diagnostic process from first to last appointment, were both negatively related to patenting stress. In contrast, mothers’ perceptions of the speed and helpfulness of the process were negatively related to levels of anxiety and depression. The number of professionals involved in the process and the perceived coherence of the diagnosis were also negatively related to aspects of mothers’ functioning. CONCLUSIONS: Care is needed to help mothers through the diagnostic process with regard to their own functioning. Providing information and help sources throughout the process, while keeping the number of professionals involved to a minimum, may improve the parent perception of the process and reduce the negative impacts of the diagnosis on the family as a whole.
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15. Robison JE. {{Kanner, Asperger, and Frankl: A third man at the genesis of the autism diagnosis}}. {Autism};2016 (Sep 13)
Scholars have long speculated about how Kanner and Asperger’s descriptions of autistic behavior appeared just 1 year apart in America and Austria even as World War II had severed communication between the two countries. Both conspiracy and serendipity have been alleged, but a simpler explanation has now emerged. Autistic knowledge crossed the Atlantic with Georg Frankl-a previously unrecognized « man in the middle » who followed his fiance to America. The evidence presented here fills in many blanks and suggests both Kanner and Asperger benefited from Frankl’s insight. He was a guiding force for both men: unseen until now because he left very little in the way of published papers. To the end of their lives, Kanner and Asperger described their conditions as separate and distinct. Today, they are both part of the Autism Spectrum in Diagnostic and Statistical Manual of Mental Disorders (5th ed.). This article explains how and why Kanner and Asperger saw their descriptions as different. It makes the case that Georg Frankl helped both men see autism as we know it today and first saw the breadth of that continuum.
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16. Schuwerk T, Sodian B, Paulus M. {{Cognitive Mechanisms Underlying Action Prediction in Children and Adults with Autism Spectrum Condition}}. {J Autism Dev Disord};2016 (Sep 13)
Recent research suggests that impaired action prediction is at the core of social interaction deficits in autism spectrum condition (ASC). Here, we targeted two cognitive mechanisms that are thought to underlie the prediction of others’ actions: statistical learning and efficiency considerations. We measured proactive eye movements of 10-year-old children and adults with and without ASC in anticipation of an agent’s repeatedly presented action. Participants with ASC showed a generally weaker tendency to generate action predictions. Further analyses revealed that statistical learning led to systematic accurate action predictions in the control groups. Participants with ASC were impaired in their ability to use frequency information for action predictions. Our findings inform etiological models of impaired social interaction in ASC.
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17. Selanikyo E, Yalon-Chamovitz S, Weintraub N. {{Enhancing classroom participation of students with intellectual and developmental disabilities}}. {Can J Occup Ther};2016 (Sep 13)
BACKGROUND: Students with intellectual and developmental disabilities (IDD) have been found to participate less in school-based activities. PURPOSE: This study aimed to examine the effectiveness of a combined in-service and collaborative consultation intervention model for enhancing classroom participation of students with IDD. METHOD: The Collaborative Consultation for Participation of Students With IDD (Co-PID) program involved a multidisciplinary team (an occupational therapist and 17 teachers) as well as 35 students and was compared to an in-service program (20 teachers and 34 students). Students were 8 to 20 years old. The programs aimed to enhance three classroom participation components: communicating, choosing, and initiating. FINDINGS: The Co-PID was found to significantly improve students’ participation in all areas, whereas the participation of the students in the in-service group decreased. IMPLICATIONS: A school-based multidisciplinary intervention program for students with IDD, combining in-service and collaborative consultation (e.g., Co-PID), may assist in enhancing classroom participation among students with IDD.
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18. Takasaki Y, Koide T, Wang C, Kimura H, Xing J, Kushima I, Ishizuka K, Mori D, Sekiguchi M, Ikeda M, Aizawa M, Tsurumaru N, Iwayama Y, Yoshimi A, Arioka Y, Yoshida M, Noma H, Oya-Ito T, Nakamura Y, Kunimoto S, Aleksic B, Uno Y, Okada T, Ujike H, Egawa J, Kuwabara H, Someya T, Yoshikawa T, Iwata N, Ozaki N. {{Mutation screening of GRIN2B in schizophrenia and autism spectrum disorder in a Japanese population}}. {Sci Rep};2016;6:33311.
N-methyl-d-aspartate receptors (NMDARs) play a critical role in excitatory synaptic transmission and plasticity in the central nervous systems. Recent genetics studies in schizophrenia (SCZ) show that SCZ is susceptible to NMDARs and the NMDAR signaling complex. In autism spectrum disorder (ASD), several studies report dysregulation of NMDARs as a risk factor for ASD. To further examine the association between NMDARs and SCZ/ASD development, we conducted a mutation screening study of GRIN2B which encodes NR2B subunit of NMDARs, to identify rare mutations that potentially cause diseases, in SCZ and ASD patients (n = 574 and 152, respectively). This was followed by an association study in a large sample set of SCZ, ASD, and normal healthy controls (n = 4145, 381, and 4432, respectively). We identified five rare missense mutations through the mutation screening of GRIN2B. Although no statistically significant association between any single mutation and SCZ or ASD was found, one of its variant, K1292R, is found only in the patient group. To further examine the association between mutations in GRIN2B and SCZ/ASD development, a larger sample size and functional experiments are needed.
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19. Wagner JB, Luyster RJ, Tager-Flusberg H, Nelson CA. {{Greater Pupil Size in Response to Emotional Faces as an Early Marker of Social-Communicative Difficulties in Infants at High Risk for Autism}}. {Infancy};2016 (Sep-Oct);21(5):560-581.
When scanning faces, individuals with autism spectrum disorder (ASD) have shown reduced visual attention (e.g., less time on eyes) and atypical autonomic responses (e.g., heightened arousal). To understand how these differences might explain sub-clinical variability in social functioning, 9-month-olds, with or without a family history of ASD, viewed emotionally-expressive faces, and gaze and pupil diameter (a measure of autonomic activation) were recorded using eye-tracking. Infants at high-risk for ASD with no subsequent clinical diagnosis (HRA-) and low-risk controls (LRC) showed similar face scanning and attention to eyes and mouth. Attention was overall greater to eyes than mouth, but this varied as a function of the emotion presented. HRA- showed significantly larger pupil size than LRC. Correlations between scanning at 9 months, pupil size at 9 months, and 18-month social-communicative behavior, revealed positive associations between pupil size and attention to both face and eyes at 9 months in LRC, and a negative association between 9-month pupil size and 18-month social-communicative behavior in HRA-. The present findings point to heightened autonomic arousal in HRA-. Further, with greater arousal relating to worse social-communicative functioning at 18 months, this work points to a mechanism by which unaffected siblings might develop atypical social behavior.
