Response to Joint Attention in Toddlers at Risk for Autism Spectrum Disorder: A Prospective Study

Response to joint attention (RJA) is impaired in preschoolers with autism spectrum disorder (ASD) and is pivotal to social and communication development. Response to joint attention was examined at 14 and 24 months in 51 children at high risk for autism (siblings of children with autism). Outcome groups at age 3 years included ASD (n = 16), broader autism phenotype (n = 8), and non-broader autism phenotype (n = 27). The ASD group made minimal improvement in RJA between 14 and 24 months, but stability of RJA across tasks increased for all three groups. Significantly, lower RJA was observed for the ASD group at 24 months. Response to joint attention performance at 14 months predicted ASD outcome. Response to joint attention is an important screening and early intervention target.     

Regulatory Behaviors and Stress Reactivity among Infants at High Risk for Fetal Alcohol Spectrum Disorders: An Exploratory Study

ABSTRACT

Introduction: This article examines regulatory behaviors and physiological stress reactivity among 6–15 month–old infants with moderate to heavy prenatal alcohol exposure (PAE), a group at very high risk for fetal alcohol spectrum disorders and self–regulation impairments, compared to low risk infants with no/low exposure. Participants: Eighteen infants and their biological mothers; nine infants [M= 10.7 (3.1) months] had moderate to heavy PAE and nine [M= 10.7 (2.9) months] had no/low exposure. Methods: Infant biobehavioral responses to the Still Face Paradigm (SFP), a standardized infant social stressor, were examined. Infant behaviors were compared across: 1) play; 2) still–face (stressor); and 3) reunion conditions, using the Infant and Caregiver Engagement Phases coding system. Salivary cortisol samples were taken at baseline, 15 and 30 minutes post SFP. Mothers completed the Infant–Toddler Symptom Questionnaire (ITSC) and Infant Behavior Questionnaire–Revised (IBQ–R). Results: Infants with PAE had significantly higher baseline salivary cortisol levels [0.26 mg/dl (.12 SD)] than controls [0.11 mg/dl (0.03 SD; p ≤ .05]. Behaviorally, infants with PAE demonstrated significantly fewer social monitoring behaviors compared to controls. There were no significant group differences on caregiver-reported regulatory behaviors (ITSC) or temperament characteristics (IBQ–R). Conclusion: Biobehavioral findings revealed greater stress vulnerability and heightened risk for regulatory problems among infants with high–risk levels of PAE. Results need confirmation with a larger sample. These exploratory findings inform future studies designed to investigate early developmental problems among children with PAE and FASD, and support an overarching goal to improve early identification and early intervention strategies for a group of high–risk infants.     

Intervention for Infants at Risk of Developing Autism: A Case Series

Theory and evidence suggest the potential value of prodromal intervention for infants at risk of developing autism. We report an initial case series (n = 8) of a parent-mediated, video-aided and interaction-focused intervention with infant siblings of autistic probands, beginning at 8–10 months of age. We outline the theory and evidence base behind this model and present data on feasibility, acceptability and measures ranging from parent-infant social interaction, to infant atypical behaviors, attention and cognition. The intervention proves to be both feasible and acceptable to families. Measurement across domains was successful and on larger samples promise to be an effective test of whether such an intervention in infancy will modify emergent atypical developmental trajectories in infants at risk for autism.     

An Investigation of Attention and Affect in Children with Autism and Down Syndrome

Longitudinal videotape recordings of six young children with autism and six age- and language-matched children with Down syndrome in structured play with their mothers at home were coded for the focus of the child's visual attention for four bimonthly visits and for facial affect for two of the four visits. The main finding was that the children with autism showed reduced expression of positive affect in a familiar social context. The autistic group attended to the mother's face and the researchers only about half as much as the Down syndrome group, but these differences did not reach statistical significance. Compared to the Down syndrome group, the autistic group displayed a smaller proportion of their total positive affect toward the mother's face and toward the researcher, but only the latter group difference reached statistical significance. Although limited by the small sample size, these findings suggest that autistic children's known deficits in attention and affective responsiveness to others persist even in structured interactions with a familiar partner in the home.     

The Collateral Effects of Joint Attention Training on Social Initiations, Positive Affect, Imitation, and Spontaneous Speech for Young Children with Autism

Joint attention may be a core deficit in autism which underlies the abnormal development of later emerging social-communication behaviors. Given this theory, researchers have suggested that teaching young children with autism to engage in joint attention may lead to collateral increases in other non-targeted social-communication behaviors. In this study, children with autism participated in a 10-week joint attention training program and collateral changes in non-targeted behaviors were assessed. Following participation in the intervention, positive collateral changes were observed in social initiations, positive affect, imitation, play, and spontaneous speech. Results support the hypothesis that teaching joint attention skills leads to improvement in a variety of related skills and have implications for the treatment of young children with autism.     

Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study

Journal of Autism and Developmental Disorders - Depression is a common comorbidity in autism spectrum disorder (ASD). Little is known about risk factors for depression and depressive symptoms in...     

Correction to: Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study

Journal of Autism and Developmental Disorders -     

Differing Developmental Trajectories in Heart Rate Responses to Speech Stimuli in Infants at High and Low Risk for Autism Spectrum Disorder

We investigated heart rate (HR) in infants at 3, 6, 9, and 12 months of age, at high (HRA) and low (LRC) familial risk for ASD, to identify potential endophenotypes of ASD risk related to attentional responses. HR was extracted from functional near-infrared spectroscopy recordings while infants listened to speech stimuli. Longitudinal analysis revealed that HRA infants and males generally had lower baseline HR than LRC infants and females. HRA infants showed decreased HR responses to early trials over development, while LRC infants showed increased responses. These findings suggest altered developmental trajectories in physiological responses to speech stimuli over the first year of life, with HRA infants showing less social orienting over time.     

The Development of Coordinated Communication in Infants at Heightened Risk for Autism Spectrum Disorder

Journal of Autism and Developmental Disorders - This study evaluated the extent to which developmental change in coordination of social communication in early infancy differentiates children...     

An Eye-Tracking Study of Attention Biases in Children at High Familial Risk for Depression and Their Parents with Depression

Child Psychiatry & Human Development - Attention biases (AB) are a core component of cognitive models of depression yet it is unclear what role they play in the transgenerational transmission...     

Potential Risk Factors for the Development of Self-Injurious Behavior among Infants at Risk for Autism Spectrum Disorder

Prevalence of self-injurious behavior (SIB) is as high as 50% among children with autism spectrum disorder (ASD). Identification of risk factors for the development of SIB is critical to early intervention and prevention. However, there is little empirical research utilizing a prospective design to identify early risk factors for SIB. The purpose of this study was to evaluate behavioral characteristics predicting SIB at age 2 years among 235 infants at high familial risk for ASD. Logistic regression results indicated that presence of SIB or proto-SIB and lower developmental functioning at age 12 months significantly predicted SIB at 24 months. A pattern of persistent SIB over this period was associated with a diagnosis of autism and poorer cognitive and adaptive outcomes.     

Shifting Attention and Joint Attention Dissociation in Williams Syndrome: Implications for the Cerebellum and Social Deficits in Autism

An experimental paradigm that assesses one’s capacity to perform intermodality attention shifting has proved to be sensitive for persons with cerebellar dysfunction. The basic experiment includes three conditions, auditory focus, visual focus and shift attention. In the auditory focus condition, the participant is instructed to press a joystick button when they hear the target tone and to ignore the other tone and the two visual stimuli. In the visual focus condition, the participant is instructed to press only the button to the target colored square and to ignore the other colored square and the two tones. In the shift attention condition, the participant is instructed to press the button to the first auditory target and then to press to the nest visual target. They are instructed to continue to alternate their responses between auditory and visual targets until the trial is complete. Three individuals with Williams Syndrome (WMS), a genetic disorder due to the deletion of the elastin gene, were examined under these experimental conditions. Each participant with WMS had previously completed magnetic resonance imaging, and mid-sagittal area measurements had been made of the vermal lobules I–V and VI–VII. Cases were selected on the basis of cerebellar findings: one case was hypoplastic, one was hyperplastic and one had measurements in a range within one standard deviation of average for normal controls. Each of the WMS participants showed a pattern of being impaired in being able to shift their attention rapidly when cue-to-target intervals were less than 2.5 s. Their performance was very similar to previous reports of persons with cerebellar abnormalities and persons with autism. All three participants improved their target accuracy when given time to shift their attention. The three participants did not experience performance deficits to either long or short cue-to-target intervals in the auditory focus or visual focus conditions. The results are consistent with the presence of cerebellar dysfunction, and are the first to suggest problems with shifting attention in persons with WMS. However, the participants demonstrated normal joint attention and had none of the social deficits observed in persons with autism.     

Dyadic Orienting and Joint Attention in Preschool Children with Autism

Acts of dyadic orienting (responses to attention bids by a researcher) and acts of joint attention (e.g. pointing and showing behaviors) were observed in preschool children with autism and children with developmental delay. Children with autism responded to fewer adult vocal and non-vocal attention bids that were made singly and by combining modalities (e.g. name call plus touch). Sensitivity in dyadic orienting was significantly related to child-initiated acts of joint attention (IJA). Sensitivity to dyadic orienting was also significantly related to language and non-verbal ability. These findings indicate that dyadic orienting difficulties are found alongside triadic joint attention difficulties in children with autism.