Rate of head growth decelerates and symptoms worsen in the second year of life in autism.

BACKGROUND: Longitudinal studies of head circumference growth in infants later diagnosed with autism are needed to understand the accelerated head growth in this disorder. METHODS: We analyzed longitudinal head circumference data from birth to 3 years in 28 children later diagnosed with autism spectrum disorder on the basis of individual growth curve analyses using hierarchical linear models. RESULTS: Head circumference Z scores relative to norms significantly increased in the autism sample from birth to 12 months, but this pattern did not persist beyond 12 months. Rather, the rate of change in head circumference from 12 to 36 months was not different from the normative sample. CONCLUSIONS: These results suggest that a period of exceptionally rapid head growth occurs during the first year of life in autism; after 12 months of age, the rate of head circumference growth decelerates relative to the rate during the first year of life. Studies of behavioral development in infants later diagnosed with autism suggest that the period of acceleration of head growth precedes and overlaps with the onset of behavioral symptoms, and the period of deceleration coincides with a period of worsening of symptoms in the second year of life.     

Brief report: cognitive correlates of enlarged head circumference in children with autism

This study examined the frequency and cognitive correlates of enlarged head circumference in a sample of 63 children with autism between the ages of 4 and 14. Consistent with prior evidence, macrocephaly occurred at a significantly higher frequency than in a normal reference sample. Head circumference was not associated with language or executive functioning, nor was it related to verbal or nonverbal IQ. Head circumference was, however, correlated with discrepancies between verbal and nonverbal IQ scores, independent of absolute level of verbal ability. Children with discrepantly high nonverbal abilities had a mean standardized head circumference that was more than 1 SD greater than in the reference sample, and that was significantly greater than in autistic children with a relative verbal advantage or no discrepancy in cognitive abilities, for whom mean head circumference was within normal limits. This convergence of physical and cognitive features suggests a possible etiologically significant subtype of autism.     

Associations between head circumference, leg length and dementia in a Korean population

BACKGROUND: Adult leg length is influenced by nutritional intake in childhood. Shorter leg length has been found to be associated with adverse health outcomes in late life, including dementia. Smaller head circumference has also been found to be associated with dementia. The independence of these two potential markers of risk for dementia has not been investigated. METHODS: Community residents aged 65 or over (n = 916) within a defined geographic area of South Korea were screened clinically for dementia and dementia subtypes. Data on anthropometric measures (head circumference and leg length), demographics (age, gender), apolipoprotein E, and early life environment (birth order, number of siblings, parental occupation, area of residence, education) were gathered. Reproductive history was also ascertained in women. RESULTS: Both smaller head circumference and shorter leg length were associated with increased age, rural residence in childhood and lower education. After adjustment for these factors, they were both independently associated with Alzheimer's disease but only in women. CONCLUSIONS: Smaller head size and shorter limb length were associated with lower early-life socio-economic status. Both factors were apparently independent markers of risk for dementia which may indicate risk factors occurring in childhood affecting both brain and skeletal development. Associations were principally present in women. Reasons for gender differences in associations require clarification but, for this population and age group, may include preferential treatment of male children.     

Autism spectrum disorders in children with seizures in the first year of life - a population-based study

PURPOSE: To describe autistic spectrum disorders (ASDs) in a cohort of children with history of unprovoked seizures other than infantile spasms in the first year of life. METHODS: The source of data was computer records from all the three pediatric departments in Iceland. Children diagnosed 1982-2000 with unprovoked seizures with onset between 28 days and 12 months of age (N = 102) were invited to participate in a study. Children with known developmental disorders and those whose parents had concerns regarding their child's development or behavior were investigated for possible ASD. Parents were asked to complete the Social Communication Questionnaire and children scoring 10 points or higher were further examined with the Autism Diagnostic Interview-Revised and observational measures. RESULTS: Eighty-four children (82.4%), 28 boys and 56 girls, participated in the study and 36.9% (31/84) were investigated for possible ASD. Twenty-four (28.6%) had at least one neurodevelopmental disorder, 14.3% had mental retardation (MR), and six (7.1%) were diagnosed with ASD, all of whom also had MR and three of whom had congenital brain abnormalities. CONCLUSION: These results suggest that the estimated prevalence of ASD is higher in children with history of seizure in the first year of life than it is in the general population. There are indications that support the view that children with ASD and history of seizure in the first year of life have higher prevalence of congenital brain abnormalities and are more often female, than other children with ASD.     

Rapidly growing head circumference as an isolated presenting symptom of brain abscesses in an infant

A rapid and excessive enlargement in occipito frontal circumference (OFC) as the only manifestation of multiple cerebral abscesses in infancy is extremely rare. A 2-month-old asymptomatic infant presenting with increasing OFC is described. Surgical drainage of the cerebral abscesses followed by prolonged antibiotic therapy resulted in complete recovery.     

Tracing back to the onset of abnormal head circumference growth in Italian children with autism spectrum disorder

This retrospective study aims to describe head circumference (HC) developmental course during the first year of life in 50 Italian children with autism spectrum disorder (ASD) and in a control group of 100 typically developing children (TD). To this end, we use anthropometric measurements (HC, body height, body weight) obtained at birth (T0), 1-2 months (T1), 3-5 months (T2) and 6-12 months (T3) from paediatricians and reported in the infant's ‘baby book’. Data indicate that at T2 and T3 HC was significantly greater in ASD group compared to TD, while from T1 weight was significantly smaller in ASD subjects compared to healthy infants. After controlling for weight and height, ASD HC shows an excessive rate of growth from birth. The abnormal HC growth is present in the majority of infants with ASD and could represent a biomarker that together with other clinical signs might promote an early ASD identification.     

A longer body length and larger head circumference at term significantly influences a better subsequent psychomotor development in very-low-birth-weight infants

Aim

To clarify the influence of intra- and extra-uterine growth on subsequent psychomotor development in very-low-birth-weight (VLBW) infants.

Head Circumference as an Early Predictor of Autism Symptoms in Younger Siblings of Children with Autism Spectrum Disorder

Siblings of children with autism have an increased risk for autism spectrum disorders (ASD). As children with autism often exhibit an atypical trajectory of head circumference (HC) growth, HC may be an indicator of vulnerability to autism. This study investigated whether infant siblings of children with ASD (n = 77) with an atypical trajectory of HC growth were more likely than those without an atypical HC trajectory to develop autism symptoms. Results showed that infants who had larger HC at 12 months, and whose HC growth rate decelerated more rapidly between 12 and 24 months were more likely to exhibit autism symptoms than infants with more typical HC trajectories. Among infant siblings of children with autism, atypical HC growth might alert pediatricians to provide screening and/or referral for further evaluation.     

Head circumference and body growth in autism spectrum disorders

Research has shown that there is a relationship between increased head circumference and autism spectrum disorders (ASD). This study examined this relationship during the first year of life in subjects with ASD. We compared 280 children with ASD and 609 controls. In the ASD-male group, increases were observed in head circumference from 3 to 12 months, in height from 3 to 9 months, and in body weight from 3 to 6 and 12 months. On the other hand, in the ASD-female group increases in head circumference, in body height, and in body weight were only observed at 3 months. After adjusting for height, weight, and age, only the head circumference in the male ASD group was significantly increased from 6 to 9 months after birth, reaching a peak at 6 months after birth. No difference was found in the female ASD group. Although body overgrowth in the ASD group also started early after birth, the increase in head circumference was more marked than that in body growth. The values of physical measurements in the first year may be useful, minimally invasive parameters for the early detection of autism in combination with observing the timing of certain behaviors such as smiling, eye contact, crawling, pointing, and joint attention.     

Timing of Prenatal Stressors and Autism

Recent evidence supports a role for genetics in autism, but other findings are difficult to reconcile with a purely genetic cause. Pathological changes in the cerebellum in autism are thought to correspond to an event before 30–32 weeks gestation. Our purpose was to determine whether there is an increased incidence of stressors in autism before this time period. Surveys regarding incidence and timing of prenatal stressors were distributed to specialized schools and clinics for autism and Down syndrome, and to mothers of children without neurodevelopmental diagnoses in walk-in clinics. Incidence of stressors during each 4-week block of pregnancy was recorded. Incidence of stressors in the blocks prior to and including the predicted time period (21–32 weeks gestation) in each group of surveys was compared to the other prenatal blocks. A higher incidence of prenatal stressors was found in autism at 21–32 weeks gestation, with a peak at 25–28 weeks. This does support the possibility of prenatal stressors as a potential contributor to autism, with the timing of stressors consistent with the embryological age suggested by neuroanatomical findings seen in the cerebellum in autism. Future prospective studies would be needed to confirm this finding.     

Head circumference,body growth and development quotient in autism spectrum disorders are related in Chongqing,China

BackgroundIt is unclear whether increased head circumference (HC) is actually an artifact of an overall overgrowth phenomenon or specific to the brain at all in autism spectrum disorders. This study compared the head circumferences, body weight and height of ASD children with a control group. We also discuss whether HC, body weight and height are correlated with development quotients in ASD children.MethodWe recruited 83 children with ASD (aged 2–5 years); they were gender and age matched to typically developing children in Chongqing (China) from 2013 to 2015. Their head circumference, body weight and height were collected. The ASD group was tested for the developmental quotient (DQ), which includes gross motor, fine motor, linguistic, personal-social and adaptive functioning.ResultsOur results showed that head circumference in the ASD group is significantly different from HC in the control group. The rate of macrocephaly was higher in the children with ASD compared with the control group. Some domains of DQ have statistically significant negative correlation with head circumference, weight and height. After adjusting for confounding factors, the fine motor was associated negatively with HC. Personal-social ability was associated negatively with weight. Gross motor was correlated negatively with the height.ConclusionsBased on our results, we found significant HC differences in ASD group while lack of effect of either height or weight at the age of 2–5. HC, weight and height were separately negative correlated with some domains of development quotients. Further research is needed to understand the relationship between physical indicators and development level in autism.     

Intracranial tumors in the first year of life

Among 100 childhood brain tumors treated at Kobe Children's Hospital from May 1970 to June 1985, 18 of the children presented with symptoms during the first year of life. This paper analyzes these 18 cases. Supratentorial tumors (78%) were more common than infratentorial ones, and 67% of all the tumors were located in the central neural axis. Initial symptoms were cranial enlargement (56%), vomiting (17%), cranial deformity (11%), blepharoptosis, respiratory distress, and ataxia. Histological diagnosis of the tumors was as follows: teratoma (3 cases), medulloblastoma (3), glioblastoma (2), astrocytoma (2), ependymoma (2), craniopharyngioma (1), choroid plexus papilloma (1), hamartoma (1), lipoma (1), melanotic progonoma (1), and an undetermined type, probably medulloblastoma (1). Seventeen of the patients underwent craniotomy for tumor resection (4 total, 4 subtotal and 7 partial removal, and 2 biopsies). Additional therapeutic methods used separately and in various combinations included ventriculoperitoneal shunt, subduralperitoneal shunt, ventricular drainage, radiotherapy and chemotherapy. Nine patients died (average 98 days) after surgery. Of the 9 survivors, 6 are still alive after more than 5 years. Five of the 6 are mentally retarded and 4 are physically handicapped to some degree.Presented at the 13th Annual Meeting of the International Society for Pediatric Neurosurgery     

Caregiver stress during the first year after diagnosis of an Autism Spectrum Disorder

Caregiver burden and marital adjustment of mothers of children diagnosed with Autism Spectrum Disorder (ASD) were assessed at baseline, i.e., within six months of diagnosis (n = 79), and again 12 months later (n = 65), using predictors from the double ABCX family adaptation model, e.g., life demands, social support, appraisal, coping. Although there were no changes over time in burden or marital adjustment, participants reported increased positive appraisals of having a child with autism, increased support from providers and decreased use of problem focused coping. Cross-sectionally at Time 2, hypothesized predictors of marital adjustment and caregiver burden derived from the literature and from stress and coping theory (Lazarus & Folkman, 1984) were largely confirmed. Longitudinally, after adjusting for baseline levels in the multiple regressions, better marital adjustment at 12 months was associated with changes over time in three predictor variables: decreased negative appraisal, decreased pile-up stress, and increased general social support. Predictors of increased caregiver burden at 12 months, after adjusting for baseline levels, were increased negative appraisal, increased avoidant coping and decreased problem focused coping.     

Behavioral manifestations of autism in the first year of life

In the interest of more systematically documenting the early signs of autism, and of testing specific hypotheses regarding their underlying neurodevelopmental substrates, we have initiated a longitudinal study of high-risk infants, all of whom have an older sibling diagnosed with an autistic spectrum disorder. Our sample currently includes 150 infant siblings, including 65 who have been followed to age 24 months, who are the focus of this paper. We have also followed a comparison group of low-risk infants. Our measures include a novel observational scale (the first, to our knowledge, that is designed to assess autism-specific behavior in infants), a computerized visual orienting task, and standardized measures of temperament, cognitive and language development. Our preliminary results indicate that by 12 months of age, siblings who are later diagnosed with autism may be distinguished from other siblings and low-risk controls on the basis of: (1) several specific behavioral markers, including atypicalities in eye contact, visual tracking, disengagement of visual attention, orienting to name, imitation, social smiling, reactivity, social interest and affect, and sensory-oriented behaviors; (2) prolonged latency to disengage visual attention; (3) a characteristic pattern of early temperament, with marked passivity and decreased activity level at 6 months, followed by extreme distress reactions, a tendency to fixate on particular objects in the environment, and decreased expression of positive affect by 12 months; and (4) delayed expressive and receptive language. We discuss these findings in the context of various neural networks thought to underlie neurodevelopmental abnormalities in autism, including poor visual orienting. Over time, as we are able to prospectively study larger numbers and to examine interrelationships among both early-developing behaviors and biological indices of interest, we hope this work will advance current understanding of the neurodevelopmental origins of autism.     

Clinical, morphological, and biochemical correlates of head circumference in autism.

BACKGROUND: Head growth rates are often accelerated in autism. This study is aimed at defining the clinical, morphological, and biochemical correlates of head circumference in autistic patients. METHODS: Fronto-occipital head circumference was measured in 241 nonsyndromic autistic patients, 3 to 16 years old, diagnosed according to DSM-IV criteria. We assessed 1) clinical parameters using the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, Vineland Adaptive Behavioral Scales, intelligence quotient measures, and an ad hoc clinical history questionnaire; 2) height and weight; 3) serotonin (5-HT) blood levels and peptiduria. RESULTS: The distribution of cranial circumference is significantly skewed toward larger head sizes (p < .00001). Macrocephaly (i.e., head circumference >97th percentile) is generally part of a broader macrosomic endophenotype, characterized by highly significant correlations between head circumference, weight, and height (p < .001). A head circumference >75th percentile is associated with more impaired adaptive behaviors and with less impairment in IQ measures and motor and verbal language development. Surprisingly, larger head sizes are significantly associated with a positive history of allergic/immune disorders both in the patient and in his/her first-degree relatives. CONCLUSIONS: Our study demonstrates the existence of a macrosomic endophenotype in autism and points toward pathogenetic links with immune dysfunctions that we speculate either lead to or are associated with increased cell cycle progression and/or decreased apoptosis.     

Body length and head growth in the first year of life in autism

Data on the growth of the head in the first year of life in children with autism spectrum disorders are inconsistent. We measured head circumference and body length during the first year of life, and determined whether the head grew in proportion to body length. This is a case-control study nested in a population-based screening study of autism spectrum disorders. Longitudinal data for head circumference and body length of 53 children with autism spectrum disorders were compared with those of a control group and population norms, using univariate and multilevel statistical modeling. Growth of body length was accelerated, but growth of head circumference was normal in children with autism spectrum disorders compared with controls in the first year of life. The rate of macrocephaly we detected in the first year of life in our sample, 11.3%, fits within the 95% confidence intervals of macrocephaly rates in previous studies. Our findings suggest that autism spectrum disorder is due to a dysregulation of growth in general, rather than to a dysregulation of neuronal growth in the brain. It is unclear whether this early, disproportionate growth of children with autism spectrum disorders is specific to the disorder, and whether this growth could serve as a biomarker to delineate more homogeneous subtypes of autism spectrum disorders.     

Symptoms in the first two years of life

Summary A population sample of autistic children (n = 26) were compared retrospectively with age-and sex-matched mentally retarded children (n = 20) and age- and sex-matched population-representative children (n = 25) on a 130-item questionnaire to the mother concerning characteristic features of the child's behaviour in the first 2 years of life. Thirteen items discriminated clearly between the groups. The results are discussed in the context of early screening for autism.