Predicting risk and resilience in ASD through social visual engagement

通过社交视觉参与预测自闭症谱系障碍的风险和恢复力

• 批准号: 9312346
• 负责人: Warren Jones
• 金额: --
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9312346
• 关键词: Address; Age-Months; Area; Autistic Disorder; Behavioral; Birth; Caregivers; Child; Classification; Clinical; Data; Data Collection; Development; Developmental Delay Disorders; Diagnosis; Diagnostic; Elderly; Enrollment; Eye; Future; Genes; Genetic; Goals; Growth; Heterogeneity; Impairment; Infant; Intervention; Laboratories; Life; Literature; Measures; Neurobiology; Ocular Fixation; Oral cavity; Outcome; Pathogenesis; Performance; Phenotype; Phylogeny; Play; Prevalence; Procedures; Prognostic Marker; Recording of previous events; Research; Risk; Risk Factors; Scanning; Sensitivity and Specificity; Severities; Siblings; Social Development; Techniques; Testing; Toddler; Treatment outcome; United States National Institutes of Health; Visual; autism spectrum disorder; base; cohort; diagnostic biomarker; disability; endophenotype; high risk; improved outcome; indexing; infancy; novel; peer; rate of change; relating to nervous system; resilience; response; sample fixation; social; social skills; treatment response

The present application builds on recent research in our laboratory in which we collected data, beginning in the first 2 months of life, from infants at high-risk for autism spectrum disorder (ASD). Following confirmatory diagnosis at 36 months, analyses of ASD-positive infants revealed that when looking at an approaching caregiver, from at least 2 months of age, infants with ASD follow a significantly different developmental trajectory from typical peers, with decline in fixation on others' eyes and increased fixation on body and object areas. Longitudinal change in measures of their visual fixation to caregivers was highly correlated with severity of clinical outcome at 24 months. In addition, based only on data collected in the first 6 months of life, measures of their developmental rate of change in looking at others' eyes and bodies predicted diagnostic classification with high sensitivity and specificity. To our knowledge, these are the eariiest known indicators of ASD in the extant literature and mark crucial first steps in advancing our understanding of the developmental pathogenesis of ASD. They also advance our efforts to enable the eariiest possible diagnostic identification of ASD-a critical factor in promoting optimal long-term outcome. The present application will build on these findings to study developmental profiles of social visual engagement as risk indices (Aim 1); as profiles for positive outcome (Aim 2); and as predictors of treatment response in eariy intervention (Aim 3). A cohort of 330 infants will be enrolled in this project, consisting of infant siblings of children with autism who are at High Risk for developing an ASD (HR-ASD, N=230); infants at High Risk for Developmental Delays without familial history of ASD (HR-DD, N=50); and children at Low Risk of developmental delays, with Typical Development expected (LR-TDx, N=50). Data will be collected longitudinally and prospectively, beginning in the first month of life, with confirmatory diagnostic assessment at 36 months. This project directly addresses several of the aspirational goals for autism set forth by the NIH Interagency Autism Coordinating Committee, with emphasis on identification of eariy risk; measures of developmental pathogenesis; and prognostic indicators for treatment and outcome.

目前的应用程序建立在我们收集数据的最新研究基础上，始于 生命的前两个月，来自自闭症谱系障碍的高风险婴儿（ASD）。下列的 在36个月的确认性诊断中，对ASD阳性婴儿的分析表明，当看一看 接近护理人员，从至少2个月大的时候开始，患有ASD的婴儿遵循明显不同 典型同龄人的发育轨迹，对他人的眼睛的固定量下降，并增加了固定 身体和物体区域。对照料者的视觉固定度量的纵向改变是高度的 与24个月时临床结果的严重程度相关。此外，仅基于收集的数据 生命的头六个月，衡量其发育变化率的衡量衡量别人的眼睛和身体 具有高灵敏度和特异性的预测诊断分类。据我们所知，这些是 在现存文献中最热门的ASD的已知指标，并在推进我们的 了解ASD的发育发病机理。他们还促进了我们为实现 ASD促进最佳长期结局的关键因素的最大可能的诊断识别。 本应用程序将基于这些发现以研究社会视觉的发展概况 作为风险指数的参与（目标1）；作为积极结果的概况（AIM 2）；作为治疗的预测指标 耳朵干预的反应（AIM 3）。该项目将注册330名婴儿的队列，包括 自闭症儿童的婴儿兄弟姐妹患ASD的高风险（HR-ASD，n = 230）； 没有ASD的家族病史的发育延迟的高风险的婴儿（HR-DD，n = 50）；和孩子 出于发育延迟的较低风险，典型的发育预期（LR-TDX，n = 50）。数据将是 从生命的第一个月开始，纵向和前瞻性地收集 评估36个月。该项目直接解决了自闭症的一些理想目标 NIH机构间自闭症协调委员会提出，重点是确定耳道风险； 发育发病机理的测量；和预后指标用于治疗和结果。