Search

Autism is diagnosed based on social and communication difficulties, restricted and repetitive behaviours and sensory anomalies. Existing evidence indicates that anxiety and atypical sensory features are associated with restricted and repetitive behaviours, but cannot clarify the order of emergence of these traits. This study uses data from a prospective longitudinal study of infants with and without a family history of autism (N = 247; Elevated Likelihood N = 170 and Typical Likelihood N = 77). Longitudinal cross-lag models tested bidirectional pathways between parent-rated infant fear/shyness and perceptual sensitivity at 8, 14 and 24 months, and associations between these domains and parent-rated restricted and repetitive behaviours and social communication scores at 36 months. In addition to within-domain continuity, higher levels of fear/shyness at 14 months were associated with higher levels of perceptual sensitivity at 24 months. Higher levels of both fear/shyness and perceptual sensitivity at 24 months were associated with greater restricted and repetitive behaviours and social communication scores at 36 months. Results demonstrate the directionality of developmental pathways between fear/shyness and perceptual sensitivity in infancy and toddlerhood, but question theories that argue that these domains specifically underlie restricted and repetitive behaviours rather than autism. Identifying how early emerging anxiety and sensory behaviours relate to later autism is important for understanding pathways and developing targeted support for autistic children. [This article was co-authored by the BASIS Team.]

Shared difficulties with cognitive control may play a role in co-occurring mental health problems frequently observed in autistic children. We investigated how different cognitive control processes (inhibitory control, conflict resolution, cognitive flexibility) associated with traits of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and anxiety in 7-year-old children at elevated (n = 44) and typical (n = 37) familial likelihood for ASD. Poor inhibitory control was associated with higher ADHD traits. Better inhibitory control and poorer cognitive flexibility predicted higher anxiety traits. Cognitive control processes were not associated dimensionally with autistic traits, though better conflict resolution predicted greater likelihood of meeting diagnostic criteria for ASD in categorical analysis. These findings suggest that different cognitive control alterations are associated with ASD, ADHD and anxiety. [This article was co-written with the BASIS Team.]

The aim of this study was to explore the associations between temperamental reactivity and regulation and the emergence of anxiety traits in a longitudinal sample of infants enriched for later ASD. Parents of 143 infants who were at high- and low-risk for ASD rated their child's temperament traits when they were 9, 15 and 24 months old; they rated anxiety and ASD traits when they were 36 months old. The findings suggest that behavioural inhibition may be an early predictor of later anxiety in children with and without ASD and that lower levels of effortful control in children who later develop ASD may contribute to the higher expression of anxiety within this population. [The BASIS Team co-authored this article.]

Parents participating in a prospective longitudinal study of infants with older siblings with autism completed an autism screening questionnaire and were asked about any concerns relating to their child's development, and children were administered an interactive assessment conducted by a researcher at 14 months. Scores on the parent questionnaire were highest for children later diagnosed with autism. Parental concerns and scores from the examiner-led assessment distinguished children with later developmental difficulties (both autism and other developmental atypicalities) from those who were developing typically. Children about whom parents expressed concern scored higher on both the questionnaire and the interactive assessment than those without concerns. There were no significant associations between total or individual item scores from the questionnaire and interactive assessment. [The BASIS Team co-authored this article.]

We investigated infant's manual motor behaviour; specifically behaviours crossing the body midline. Infants at elevated likelihood of Autism Spectrum Disorder (ASD) and/or Attention Deficit Hyperactivity Disorder (ADHD) produced fewer manual behaviours that cross the midline compared to infants with a typical likelihood of developing these disorders; however this effect was limited to 10-month-olds and not apparent at age 5 and 14 months. Although, midline crossing did not predict ASD traits, it was related to ADHD traits at 2 years of age. We rule out motor ability and hand dominance as possible explanations for this pattern of behaviour, positing that these results may be a consequence of multisensory integration abilities, and the neurobehavioural shift period, in the first year of life. [This article was co-written by the BASIS/STAARS Team.]

Longitudinal research can assess how diverging development of multiple cognitive skills during infancy, as well as familial background, are related to the emergence of neurodevelopmental conditions. Sensorimotor and effortful control difficulties are seen in infants later diagnosed with autism; this study explored the relationships between these skills and autism characteristics in 340 infants (240 with elevated familial autism likelihood) assessed at 4–7, 8–10, 12–15, 24, and 36 months. We tested: (1) the relationship between parent‐reported effortful control (Rothbart's temperament questionnaires) and sensorimotor skills (Mullen Scales of Early Learning), using random intercept cross‐lagged panel modelling; (2) whether household income and maternal education predicted stable individual differences in cognition; (3) sensorimotor and effortful control skills as individual and interactive predictors of parent‐reported autism characteristics (Social Responsiveness Scale) at 3 years, using multiple regression; and (4) moderation of interactions by familial likelihood. Sensorimotor skills were longitudinally associated with effortful control at the subsequent measurement point from 12–15 months. Socioeconomic status indicators did not predict stable between‐infant differences in sensorimotor or effortful control skills. Effortful control skills were longitudinally related to 3‐year autism characteristics from the first year of life, with evidence for an interaction with sensorimotor skills at 24 months. Effects of effortful control increased with age and were particularly important for infants with family histories of autism. Results are discussed in relation to different theoretical frameworks: Developmental Cascades and Anterior Modifiers in the Emergence of Neurodevelopmental Disorders. We suggest a role for 24‐month effortful control in explaining the emergent autism phenotype. Research Highlights: Sensorimotor skills longitudinally predicted effortful control from 12–15 months onward but effortful control did not longitudinally predict sensorimotor skills during infancy.Measures of effortful control skills taken before the age of 1 predicted continuous variation in autism characteristics at 36 months, with associations increasing in strength with age.Effortful control (measured at 12–15 and 24 months) was a stronger predictor of 36‐month autism characteristics in infants with elevated familial likelihood for autism.The relationship between 24‐month sensorimotor skills and 36‐month autism characteristics was stronger in infants with weaker effortful control skills. [ABSTRACT FROM AUTHOR]

Cognitive markers may in theory be more sensitive to the effects of intervention than overt behavioral measures. The current study tests the impact of the Intervention with the British Autism Study of Infant Siblings—Video Interaction for Promoting Positive Parenting (iBASIS‐VIPP) on an eye‐tracking measure of social attention: dwell time to the referred object in a gaze following task. The original two‐site, two‐arm, assessor‐blinded randomized controlled trial (RCT) of this intervention to increase parental awareness, and responsiveness to their infant, was run with infants who have an elevated familial likelihood for autism (EL). Fifty‐four EL infants (28 iBASIS‐VIPP intervention, 26 no intervention) were enrolled, and the intervention took place between 9 months (baseline) and 15 months (endpoint), with gaze following behavior measured at 15 months. Secondary intention to treat (ITT) analysis showed that the intervention was associated with significantly reduced dwell time to the referent of another person's gaze (β = −0.32, SE = 0.14, p = 0.03) at 15‐month treatment endpoint. Given the established link between gaze following and language, the results are considered in the context of a previously reported, non‐significant and transient trend toward lower language scores at the treatment endpoint (Green et al. (2015) The Lancet Psychiatry, 2(2), 133–140). Future intervention trials should aim to include experimental cognitive measures, alongside behavioral measures, to investigate mechanisms associated with intervention effects. Lay Summary: The current study tests the impact of the Intervention with the British Autism Study of Infant Siblings—Video Interaction for Promoting Positive Parenting (iBASIS‐VIPP) on an eye‐tracking measure of social attention: looking time to the object of another person's gaze. Infants who received the iBASIS‐VIPP intervention spent less time looking to the object of another person's gaze. This may be linked to the previously reported trend of slightly lower language scores immediately after the intervention. These findings emphasize the need for future trials to include more fine‐grained, experimental measures of social interaction, alongside broad assessment measures, and to better understand how the intervention might change behavior. [ABSTRACT FROM AUTHOR]

Developmental antecedents of autism may affect parent–infant interactions (PII), altering the context in which core social skills develop. While studies have identified differences in PII between infants with and without elevated likelihood (EL) for autism, samples have been small. Here, we examined whether previously reported differences are replicable. From a longitudinal study of 113 EL and 27 typical likelihood infants (TL), 6‐min videotaped unstructured PII was blind rated at 8 and 14 months on eight interactional qualities. Autism outcome was assessed at 36 months. Linear mixed‐effects models found higher parent sensitive responsiveness, nondirectiveness, and mutuality ratings in TL than EL infants with and without later autism. PII qualities at 8 (infant positive affect, parent directiveness) and 14 months (infant attentiveness to parent, mutuality) predicted 3‐year autism. Attentiveness to parent decreased between 8 and 14 months in EL infants with later autism. This larger study supports previous findings of emerging alterations in PII in this group and extends on this by detecting earlier (8‐month) predictive effects of PII for autism outcome and a more marked trajectory of decreased social attentiveness. The findings strengthen the evidence base to support the implementation of early preemptive interventions to support PII in infants with early autism signs. Lay Summary: Previous studies have found parent–infant interaction (PII) differences between infants with elevated likelihood (EL) and with typical likelihood (TL) for autism. This may be due to early changes in social communication skills. However, sample sizes have been small. Here, we investigated whether we could replicate previous findings including a new larger sample by looking at whether infants at EL differed from infants at TL in PII qualities at 8 and 14 months, and whether these qualities differed in those with from those without autism diagnosis at 3 years. This study found that the TL group was rated to have more mutual play and parents played with their infant more sensitively and less directively than the EL group (infants with and without later autism). PII qualities at 8 (infant positivity, parent directiveness) and 14 months (infant interest in parent, mutual play) differed between those with and without later autism. Between 8 and 14 months, the baby's interest in the parent during play reduced faster in infants with later autism. As well as showing similar results to previous research, the larger sample has allowed us to find earlier interactional differences (8 months) and developmental changes in social attention that statistically predict a later autism diagnosis. The study highlights the importance of supporting PII in parents of EL infants in the first year of life. [ABSTRACT FROM AUTHOR]

Background: Congenital Heart Disease (CHD) is the most common congenital abnormality. Survival rates are over 90%, however infants with CHD remain at high risk of attention and executive function impairments. These abilities are difficult to assess in toddlers because clinical assessments rely on language abilities which are commonly delayed in CHD. Our aim was to characterise visual attention in toddlers with CHD compared to controls and identify associations with parent‐rated effortful control. Methods: Thirty toddlers with CHD (19 male, median (IQR) age at assessment 22.2 (22–23.1) months) and 66 controls from the developing human connectome project (36 male, age at assessment 22 (21.5–23.8) months) using eye‐tracking tasks designed to assess multiple components of visual attention. Analyses of co‐variance and regressions were used to identify differences between groups and relationships between gaze behaviours and parent‐rated effortful control. Results: Toddlers with CHD were less accurate when switching behaviours (set‐shifting) [median (IQR) 79%, (28–100)] compared to controls [100% (86–100), pFDR = 0.032], with worse accuracy associated with lower parent‐rated effortful control in CHD but not controls (interaction pFDR = 0.028). Reaction times were slower during selective [CHD 1243 ms (986–1786), controls 1065 ms (0851–1397), pFDR<0.001] and exogenous attention tasks [CHD 312 ms (279–358), control 289 (249–331), (pFDR = 0.032) and endogenous attention was less mature (prolonged looks at facial stimuli CHD 670 ms (518–885), control 500 ms (250–625), (pFDR = 0.006). These results were unrelated to differences in cognition or socioeconomic status. In contrast, the allocation of attentional resources was preserved in CHD. Conclusions: We identified a profile of altered attention and early executive functioning development in CHD. Eye‐tracking may provide clinically feasible, early objective measures of attention and executive function development in CHD. [ABSTRACT FROM AUTHOR]

Atypicalities in sensory perception are observed in individuals diagnosed with ASD and ADHD but have rarely beencontrasted in experimental studies. In the visual domain, superior performance on visual search tasks and hypersensitivity toflickering lights have been cited as evidence of unusual sensory profiles.To measure a reliable visual response, black-and-white checkerboards were presented under free-viewing conditions to threegroups of 10-month-olds: siblings of children with ASD (N=47), ADHD (N=21) and controls (N=18). Continuous EEG wasrecorded and VEPs time-locked to checkerboards presentation computed.Analysis of VEPs amplitude and latency revealed statistically significant group differences in the first 200ms post-stimulusonset. Early components were enhanced in amplitude (P100) and delayed in latency (P100-N100) in at-risk infants comparedto controls (p

Caregiver-infant interaction through touch was shown to have long-term effects on child’s cognitive development,but the mechanisms are poorly understood. Our aim is to investigate how affective touch (slow gentle caressing) affects arousalstates in young infants. Previous work showed that slow-touch decreases heart rate in 9-month-old infants.We tested two groups of 6-months-old (n=26) and 9-months-old infants (n=23). We measured heart rate and saccadic reactiontime while infants performed a visual orienting task, where speed of re-orienting from a central fixation to a peripheral targetwas measured. During the experiment, infants received either slow or fast-touch on their back in blocked trials. We found noeffects of touch on heart rate in either age-group, and only marginal effects of slow-touch on reaction times in 9-month-oldinfants. We are currently testing 2 months-old infants to investigate if these effects are observed earlier in life; these new resultswill be discussed.

It is known that affective touch leads to broad cortical activations including posterior STS, key region of the so-cial brain. Our goal is to discover if a similar pattern of activation can be observed in 5-months-old infants, or whether thedevelopment of this cortical specialization results from extensive postnatal experience.Over two studies we used functional-Near-InfraRed-Spectroscopy (fNIRS) to compare social touch (a human caress) tonon-social touch (a caress performed with a spoon in study1 -n=22- or with an electric toothbrush in study2 -n=17-).In study1 we found similar patterns of activation to the social and non-social stimulus. In study2 we report broad responsesto the non-social stimulus, but, to our surprise, we found no activations to the human caress.In light of these results we conclude that it is possible that at this age discrimination between social and non-social touch inthe posterior temporal lobe is still undergoing specialization.

Infants as young as 2 months can integrate audio and visual aspects of speech articulation. A shift of attention from the eyes towards the mouth of talking faces occurs around 6 months of age in monolingual infants. However, it is unknown whether this pattern of attention during audiovisual speech processing is influenced by speech and language experience in infancy. The present study investigated this question by analysing audiovisual speech processing in three groups of 4- to 8-month-old infants who differed in their language experience: monolinguals, unimodal bilinguals (infants exposed to two or more spoken languages) and bimodal bilinguals (hearing infants with Deaf mothers). Eye-tracking was used to study patterns of face scanning while infants were viewing faces articulating syllables with congruent, incongruent and silent auditory tracks. Monolinguals and unimodal bilinguals increased their attention to the mouth of talking faces between 4 and 8 months, while bimodal bilinguals did not show any age difference in their scanning patterns. Moreover, older (6.6 to 8 months), but not younger, monolinguals (4 to 6.5 months) showed increased visual attention to the mouth of faces articulating audiovisually incongruent rather than congruent faces, indicating surprise or novelty. In contrast, no audiovisual congruency effect was found in unimodal or bimodal bilinguals. Results suggest that speech and language experience influences audiovisual integration in infancy. Specifically, reduced or more variable experience of audiovisual speech from the primary caregiver may lead to less sensitivity to the integration of audio and visual cues of speech articulation.

A fundamental question about the development of communication behavior in early life is how infants acquire adaptive communication behavior that is well-suited to their individual social environment, and how the experience of parent-child communication affects this development. The current study investigated how infants develop communication skills when their parents are visually impaired and cannot see their infants' eye gaze. We analyzed 6-min video recordings of naturalistic interaction between 14 sighted infants of blind parents (SIBP) with (a) their blind parent, and (b) a sighted experimenter. Data coded from these interactions were compared with those from 28 age-matched sighted infants of sighted parents (controls). Each infant completed two visits, at 6-10 months and 12-16 months of age. Within each interaction sample, we coded the function (initiation or response) and form (face gaze, vocalization, or action) of each infant communication behavior. When interacting with their parents, SIBP made relatively more communicative responses than initiations, and used more face gaze and fewer actions to communicate, than did controls. When interacting with a sighted experimenter, by contrast, SIBP made slightly (but significantly) more communicative initiations than controls, but otherwise used similar forms of communication. The differential communication behavior by infants of blind versus sighted parents was already apparent by 6-10 months of age, and was specific to communication with the parent. These results highlight the flexibility in the early development of human communication behavior, which enables infants to optimize their communicative bids and methods to their unique social environment.

Background: Existing evidence indicates that atypical sensory reactivity is a core characteristic of autism, and has been linked to both anxiety (and its putative infant precursor of fearfulness) and repetitive behaviours. However, most work has used cross‐sectional designs and not considered the differential roles of hyperreactivity and hyporeactivity to sensory inputs, and is thus limited in specificity. Methods: 161 infants with and without an elevated likelihood of developing autism and attention‐deficit hyperactivity disorder (ADHD) were followed from 10 to 36 months of age. Parents rated an infant precursor of later anxiety (fearfulness) using the Infant Behaviour Questionnaire at 10 and 14 months, and the Early Childhood Behavioural Questionnaire at 24 months, and sensory hyperreactivity and hyporeactivity at 10, 14 and 24 months using the Infant Toddler Sensory Profile. Domains of autistic traits (restrictive and repetitive behaviours; RRB, and social communication interaction, SCI) were assessed using the parent‐rated Social Responsiveness Scale at 36 months. Cross‐lagged models tested (a) paths between fearfulness and hyperreactivity at 10–24 months, and from fearfulness and hyperreactivity to later autism traits, (b) the specificity of hyperreactivity effects by including hyporeactivity as a correlated predictor. Results: Hyperreactivity at 14 months was positively associated with fearfulness at 24 months, and hyperreactivity at 24 months was positively associated with SCI and RRB at 36 months. When hyporeactivity was included in the model, paths between hyperreactivity and fearfulness remained, but paths between hyperreactivity and autistic traits became nonsignificant. Conclusions: Our findings indicate that alterations in early sensory reactivity may increase the likelihood of showing fearfulness in infancy, and relate to later social interactions and repetitive behaviours, particularly in individuals with a family history of autism or ADHD. [ABSTRACT FROM AUTHOR]

Autism sibling recurrence in prospective infant family history studies is ~20% at 3 years but systematic follow‐up to mid‐childhood is rare. In population and clinical cohorts autism is not recognized in some children until school‐age or later. One hundred and fifty‐nine infants with an older sibling with autism underwent research diagnostic assessments at 3 years and mid‐childhood (6 to 12 years (mean 9)). We report the autism sibling recurrence rate in mid‐childhood and compare developmental and behavioral profiles at mid‐childhood and 3 years in those with earlier versus later recognized autism, and those who had, or had not, received a community autism diagnosis. The autism recurrence rate in this sample in mid‐childhood was 37.1%, 95% CI [29.9%, 44.9%] and higher in boys than girls. Around half of those diagnosed with autism in mid‐childhood had not received a diagnosis at 3 years. Later, diagnosis was more common in girls than boys. While some had sub‐threshold symptoms at 3, in others late diagnosis followed a largely typical early presentation. Sibling recurrence based on community clinical diagnosis was 24.5%, 95% CI [18.4%, 31.9%]. Those who also had a community diagnosis tended to be older, have lower adaptive function and higher autism and inattention symptoms. Notwithstanding limitations of a single site study, modest sample size and limits to generalisability, autism sibling recurrence in family history infants may be higher in mid‐childhood than in studies reporting diagnostic outcome at 3 years. Findings have implications for families and clinical services, and for prospective family history studies. Lay Summary: Autism sibling recurrence in prospective infant family history studies is ~20% at 3 years but follow‐up to mid‐childhood is rare although in some children autism is not recognized until school‐age or later. We assessed 159 infants with an older sibling with autism at 3 years and in mid‐childhood (9 years). The autism sibling recurrence rate in mid‐childhood was 37.1%, 95% CI [29.9%, 44.9%] and higher in boys than girls. Only half of those diagnosed with autism in mid‐childhood had received a diagnosis at 3 years and later diagnosis was more common in girls than boys. Clinicians need provide ongoing monitoring of younger siblings of autism probands to be able to offer support to families when they express concern and seek services. [ABSTRACT FROM AUTHOR]

Executive functions (EFs) are key abilities that allow us to control our thoughts and actions. Research suggests that two EFs, inhibitory control (IC) and working memory (WM), emerge around 9 months. Little is known about IC earlier in infancy and whether basic attentional processes form the "building blocks" of emerging IC. These questions were investigated longitudinally in 104 infants tested behaviorally on two screen-based attention tasks at 4 months, and on IC tasks at 6 and 9 months. Results provided no evidence that basic attention formed precursors for IC. However, there was full support for coherence in IC at 9 months and partial support for stability in IC from 6 months. This suggests that IC emerges earlier than previously assumed.

Cognitive and adaptive behaviour abilities early in life provide important clinical prognostic information. We examined stability of such skills in children at high familial risk for ASD who either met diagnostic criteria for ASD at age 7 years (HR-ASD, n = 15) or did not (HR-non-ASD, n = 24) and low-risk control children (LR, n = 37), prospectively studied from infancy. For both HR groups, cognitive skills were consistently lower across time than those of LR children. HR-ASD children showed increasing difficulties in adaptive behaviour over time compared to LR children, while the HR-non-ASD children showed no such difficulties. This pattern of change may inform our understanding of developmental profiles of HR siblings beyond core ASD symptoms.

Anxiety and threat bias were examined in 6-8-year-old children at familial-risk for Autism Spectrum Disorder (ASD) and low-risk (LR, n = 37) controls. The high-risk (HR) group was divided into those who met diagnostic criteria for ASD (HR-ASD, n = 15) and those who did not (HR-non ASD, n = 24). The HR-ASD group had highest levels of parent-reported anxiety. The HR-non ASD group exhibited increased threat bias on a spatial-cueing task, while the HR-ASD group did not. Anxiety symptoms were associated with both threat bias and ASD severity. These findings suggest that the mechanisms underlying anxiety in HR siblings without ASD are similar to those in non-ASD populations. However, among children with ASD, hypersensitivity to threat may not underlie anxiety symptoms. [This report was written with the BASIS Team.]