Autism Spectrum Disorder Symptomology Research Articles

Feasible Adaptation of ESDM for Statewide Implementation: A Look at Potential Effects, Implementation Conditions, and Cost

This article describes the development and use of a first of its kind statewide implementation of an adapted Early Start Denver Model (ESDM). Supported by a collaborative partnership between stakeholders that included families, state agencies, and a state university, the intervention was implemented within the existing framework of a northeastern state’s relationship-based Individuals with Disabilities Education Act (IDEA) Part C early intervention program. Participants were 194 families. The study examined the effectiveness and implementation costs of an adaptation of the ESDM using a coaching model to inform statewide implementation to improve outcomes for young children with autism spectrum disorder (ASD) in rural and low-resource states. Results indicated 194 children who received a monthly average of 10.90 hr of adapted ESDM for an average of 12 months demonstrated an improvement in the frequency of ASD symptomology for a total cost of US$2,511/child. Intervention intensity and child factors demonstrated varying influence on outcomes. This study contributes to the literature by demonstrating the potential for positive impact of an evidence-based practice scaled to a statewide model of early intervention for young children with ASD.

View of the Work Community and Vocational Rehabilitation Services Among Adults With Autism Spectrum Disorder

Many adults diagnosed with autism spectrum disorder (ASD) face challenges in establishing and maintaining employment. These difficulties may be related to ASD symptomology or employer attitudes; however, vocational rehabilitation (VR) can provide employment-related resources. This study sought to understand how adults with ASD view their integration into workplace communities and VR services. Qualitative data were collected from 24 adults with ASD, and analysis identified themes surrounding the importance of workplace contributions, interesting work, and positive workplace relationships contributing to feeling integrated into the workplace community. Responses were also examined for perspectives on the role of VR in supporting workplace integration. Findings indicate the importance of attending to individual employment preferences and the need for long-term VR follow-along services to explore opportunities for employment growth. Implications and future recommendations for research and practice are also discussed.

Reading enhancements for students with autism spectrum disorder: A matched randomized pilot experimental study

BackgroundFor students with autism spectrum disorder (ASD), improving reading comprehension is critical for increasing both their opportunities for successful postsecondary experiences including attending college and obtaining meaningful employment. The purpose of this pilot study was to investigate the effects of a multicomponent reading intervention on the vocabulary and reading outcomes of middle grade students with ASD. MethodWe conducted a matched randomized pilot experimental study for students with ASD in grades 3–8 (N = 28) identified by their district personnel as having reading difficulties (i.e., not passing state reading test). An independent researcher matched participants according to symptom severity and reading fluency and then randomly assigned a member of each pair to treatment or comparison condition. Participants in treatment condition were provided 1:1 instruction for 23–30 sessions (M = 27) of 30 min each four to five days per week. Instructional components included (a) vocabulary instruction; (b) fluency with text, and (c) reading comprehension. In this pilot study, data were analyzed using repeated measures multilevel models in HLM 7. Due to the associated low statistical power to detect effects, the small sample size, and the exploratory nature of the study, we selected an alpha level of 0.10. Data were modeled as student-level variables classifying students based on their ASD symptomology from mild (level 1) to severe (level 3). ResultsThe multicomponent intervention was associated with significant gains in WJ-PC scores of 22.62 (se = 8.19, df = 3, p = .070) for students at GARS severity level 1. Significant gains favoring the intervention were also detected on vocabulary score of 10.19 (se = 2.78, df = 3, p = .035) and for students rated at GARS severity level 1 and for students rated at GARS severity level 2 [vocabulary score 5.46 (se = 1.60, df = 3, p = .042)]. Significant effects were not detected for scores on a standardized measure of reading and fluency (TOSREC), and a researcher-developed measure of reading comprehension. ConclusionsThis pilot study shows enough promise to warrant future studies employing larger sample sizes and fully powered randomized control trial (RCT) studies. Although growth is modest and appears to be limited to participants who are in the mid to higher range of the autism spectrum, considering the large percentage of students with ASD in the mid to higher range, this study contributes to the development of evidence-based practices. We interpret the findings as having implications for future research with larger sample sizes and in providing initial guidance on instruction for consideration by practitioners.

Fetal Amygdala Functional Connectivity Relates to Autism Spectrum Disorder Traits at Age 3

Autism spectrum disorder (ASD) is a highly prevalent developmental disorder. There is notable disparity in occurrence rates between males and females, with males being 4.5 times as likely as their female counterparts to be diagnosed with the disease. A major objective for improving functional outcomes in ASD is to isolate biomarkers for earlier detection; an area as yet unexplored is whether biomarkers of future ASD symptomology may be observable in the fetal brain. Here, we focus on the amygdala, which shows sex-differential patterns of development and has been implicated in the neurobiology of ASD.

Coaching via Telehealth: Caregiver-Mediated Interventions for Young Children on the Waitlist for an Autism Diagnosis Using Single-Case Design.

Years can elapse between parental suspicion of a developmental delay and a diagnostic assessment, ultimately delaying access to medically necessary, autism-specific intervention. Using a single-case, concurrent multiple baseline design, autism spectrum disorder symptomology (i.e., higher-order restrictive and repetitive behaviors and interests; higher-order RRBIs) was targeted in toddlers (21–35 months) waiting for a diagnostic appointment. Caregivers were coached via telehealth to mediate early intervention to decrease interfering, inflexible higher-order RRBIs during play using four evidence-based applied behavior analytic strategies: modeling, prompting, differential reinforcement of appropriate behaviors, and response interruption and redirection. Six mother–child dyads were recruited from pediatrician offices and early intervention service districts in the United States. All families were considered under-served, under-resourced, or living in rural locations. A visual analysis of the data combined with Tau-U revealed a strong basic effect between the intervention package and parent strategy use and child flexible and inflexible behavior. Findings were consistent across participants with one exception demonstrating a moderate effect for flexible behaviors yet a strong effect for inflexible behaviors. Standardized mean difference was beyond zero for all participants. Implications for science and practice include support for early intervention of higher-order RRBIs for young children with and at risk for ASD.

Parent Emotion Socialization in Children with Autism Spectrum Disorder and Co-Occurring Anxiety.

Although parents' socialization of children's emotional experiences and expression has been widely studied in typically developing (TD) populations, these processes have been largely unexplored in families of children with autism spectrum disorder (ASD). The present study examined parent emotion socialization in a well-characterized sample of verbally fluent children with ASD and comorbid anxiety disorders. Participants included 64 children, aged 8-15years, who had ASD and co-occurring anxiety and 24 matched TD children without psychiatric disorders. Parents completed ratings of their responses to their children's emotional experiences using the Coping with Children's Negative Emotions Scale (CCNES), and both parents and children completed ratings of child anxiety using the Multidimensional Anxiety Rating Scale (MASC). Parents of children with ASD and anxiety did not differ from parents of TD children without psychiatric disorders in their endorsement of different emotion socialization practices. However, among children with ASD and anxiety, greater anxiety was associated with more emotion-focused responses from parents, and for children with less ASD symptom severity, lower levels of anxiety were associated with more punitive responses from parents. Results suggest that certain types of more directive emotion socialization approaches may be associated with lower anxiety in children with ASD, whereas emotion socialization approaches focused on altering the child's emotional experiences may be associated with greater anxiety in this population. While it is likely that parent emotion socialization practices impact children's emotional experiences of anxiety, it is also likely that children with distinct profiles of anxiety and ASD symptomology elicit specific styles of emotion socialization from parents.

Quantitative trait variation in ASD probands and toddler sibling outcomes at 24\u2009months

BackgroundYounger siblings of children with autism spectrum disorder (ASD) are at increased likelihood of receiving an ASD diagnosis and exhibiting other developmental concerns. It is unknown how quantitative variation in ASD traits and broader developmental domains in older siblings with ASD (probands) may inform outcomes in their younger siblings.MethodsParticipants included 385 pairs of toddler siblings and probands from the Infant Brain Imaging Study. ASD probands (mean age 5.5 years, range 1.7 to 15.5 years) were phenotyped using the Autism Diagnostic Interview-Revised (ADI-R), the Social Communication Questionnaire (SCQ), and the Vineland Adaptive Behavior Scales, Second Edition (VABS-II). Siblings were assessed using the ADI-R, VABS-II, Mullen Scales of Early Learning (MSEL), and Autism Diagnostic Observation Schedule (ADOS) and received a clinical best estimate diagnosis at 24 months using DSM-IV-TR criteria (n = 89 concordant for ASD; n = 296 discordant). We addressed two aims: (1) to determine whether proband characteristics are predictive of recurrence in siblings and (2) to assess associations between proband traits and sibling dimensional outcomes at 24 months.ResultsRegarding recurrence risk, proband SCQ scores were found to significantly predict sibling 24-month diagnostic outcome (OR for a 1-point increase in SCQ = 1.06; 95% CI = 1.01, 1.12). Regarding quantitative trait associations, we found no significant correlations in ASD traits among proband-sibling pairs. However, quantitative variation in proband adaptive behavior, communication, and expressive and receptive language was significantly associated with sibling outcomes in the same domains; proband scores explained 9–18% of the variation in cognition and behavior in siblings with ASD. Receptive language was particularly strongly associated in concordant pairs (ICC = 0.50, p < 0.001).ConclusionsProband ASD symptomology, indexed by the SCQ, is a predictor of familial ASD recurrence risk. While quantitative variation in social communication and restricted and repetitive behavior were not associated among sibling pairs, standardized ratings of proband language and communication explained significant variation in the same domains in the sibling at 24 months, especially among toddlers with an ASD diagnosis. These data suggest that proband characteristics can alert clinicians to areas of developmental concern for young children with familial risk for ASD.

Autism spectrum disorder, bestiality and zoophilia: a systematic PRISMA review

PurposeThere remains a lack of knowledge surrounding paraphilic or deviant arousal sexual behaviours in individuals with Autism spectrum disorder (ASD) (Kellaher, 2015). The purpose of this paper is to explore the literature for any empirical study, case study or discussion/review paper surrounding individuals with ASD and zoophilia or bestiality.Design/methodology/approachA systematic PRISMA review was conducted.FindingsThis systematic review highlighted only a small number of papers, which have looked at zoophilia or bestiality in individuals with ASD. Only one article was identified as being relevant in the present review, three further articles included a description of a case involving someone with ASD who engaged in zoophilia or bestiality and another paper, although not the focus of the study, found one person with Asperger’s disorder who had several paraphilias including olfactophilia, podophilia and zoophilia in a sample of 20 institutionalised, male adolescents and young adults with Autistic disorder and borderline/mild mental retardation. All the case studies clearly highlight some of the ASD symptomology that can contribute to engaging in bestiality or zoophilia.Practical implicationsIt is important that individuals with ASD have access to appropriate and timely sex education and that parents are supported by healthcare professionals to engage with their children with ASD in such interactions across the autism spectrum irrespective of the parent’s expectations.Originality/valueTo the author’s knowledge, this is the first review of ASD in relation to bestiality and zoophilia.

Dietary Patterns Impact Temporal Dynamics of Fecal Microbiota Composition in Children With Autism Spectrum Disorder.

Environmental factors such as diet are known influencers on gastrointestinal (GI) microbiota variability and some diseases are associated with microbial stability. Whether microbial variability is related to symptoms of Autism Spectrum Disorder (ASD) and how diet impacts microbial stability in ASD is unknown. Herein, temporal variability in stool microbiota in relation to dietary habits in 2–7 years-old children with ASD (ASD, n = 26) and unaffected controls (CONT, n = 32) was investigated. Fecal samples were collected at baseline, 6-weeks and 6-months. Bacterial composition was assessed using 16S rRNA sequencing. Short fatty acid (SCFA) concentrations were analyzed by gas chromatography. Nutrient intake was assessed using a 3-day food diary and dietary patterns (DP) were empirically derived from a food frequency questionnaire. Social deficit scores (SOCDEF) were assessed using the Pervasive Developmental Disorder Behavior Inventory-Screening Version (PDDBI-SV). GI symptoms were assessed using the GI severity index. Overall, temporal variability in microbial structure, and membership did not differ between the groups. In children with ASD, abundances of Clostridiaceae, Streptophyta, and Clostridiaceae Clostridium, varied significantly, and concentrations of all SCFAs decreased over time. Variability in community membership was negatively correlated with median SOCDEF scores. Additionally, Clostridiales, Lactococcus, Turicibacter, Dorea, and Phascolarctobacterium were components of a more stable microbiota community in children with ASD. DP1, characterized by vegetables, starchy vegetables, legumes, nuts and seeds, fruit, grains, juice and dairy, was associated with changes in species diversity, abundance of Erysipelotricaceae, Clostridiaceae Clostridium, and Oscillospira and concentrations of propionate, butyrate, isobutyrate and isovalerate in children with ASD. DP2 characterized by fried, protein and starchy foods, “Kid's meals,” condiments, and snacks was associated with variations in microbiota structure, abundance of Clostridiaceae Clostridium, and Oscillospira and changes in all SCFA concentrations. However, no association between microbial stability and SOCDEF or GI severity scores were observed. In conclusion, microbiota composition varies over time in children with ASD, might be related to social deficit scores and can be impacted by diet. Future studies investigating the physiological effect of the changes in specific microbial taxa and metabolites are needed to delineate the impact on ASD symptomology.

Firesetting and arson in individuals with autism spectrum disorder: a systematic PRISMA review

PurposeThe purpose of this paper is to identify studies which have investigated arson or firesetting in individuals with autism spectrum disorder (ASD).Design/methodology/approachA systematic PRISMA review was conducted.FindingsThe present review highlighted the relatively little research that has been conducted to date exploring firesetting or arson in individuals with ASD. In sum, 11 papers were identified in the present review study: 6 were case studies and 5 were empirical studies. The case studies identified in the review highlighted some of the ASD symptomology which may contribute to this type of criminal behaviour. Also, the empirical studies indicate that there is a higher prevalence of individuals with ASD who engage in such criminal behaviours.Research limitations/implicationsThere is an urgent need for further empirical research in this area and for there to be an increased awareness and understanding of how ASD can contribute to arson and firesetting in both a legal and clinical context.Originality/valueThis is the first review, to the author’s knowledge, to explore the literature on firesetting or arson in individuals with ASD.

Evaluation of a Combined Explicit-Implicit Approach to Teach Grammatical Forms to Children With Grammatical Weaknesses.

Purpose Many children with developmental disorders experience difficulty mastering grammatical forms, including children with developmental language disorder and a subset of children with autism spectrum disorder (ASD). One of the key language features in both of these populations is a weakness in the expressive use of grammatical forms. There is a paucity of studies that evaluate the effectiveness of interventions targeting grammatical forms for populations other than developmental language disorder. The current study evaluated a combined explicit-implicit intervention approach to teach grammatical forms to children with ASD symptomology. Method Researchers used a single-subject, nonconcurrent multiple baseline, A-B-C study design. Three children with characteristics of ASD (2 with formal diagnoses) between the ages of 5 and 9 years participated in treatment targeting a weak grammatical structure. After baseline, each participant completed a series of treatment sessions that comprised implicit instruction, followed by a series of treatment sessions that incorporated explicit instruction. Accuracy of use was assessed during each session across baseline, implicit-only, and explicit-implicit conditions as well as 1 week, 1 month, and 2 months posttreatment. Results All participants produced target forms with low accuracy across baseline and implicit-only treatment sessions. Within three explicit-implicit treatment sessions, all participants demonstrated a marked increase in level and upward trend in their production accuracy. Gains in accuracy were maintained 2 months posttreatment for 2 of the 3 participants. Conclusions The current study provides preliminary evidence to support the use of explicit approaches to teach grammatical forms to children with ASD symptomology and motivates further investigation in this area.

Autistic spectrum disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analytical review.

Research identifies highly variable prevalence estimates for autism spectrum disorder (ASD) in children and adolescents with attention deficit hyperactivity disorder (ADHD), particularly between community and clinical samples, warranting quantitative meta-analyses to investigate the true prevalence of ASD in children and adolescents with ADHD. Studies were identified through a systematic literature search of PsycINFO, MEDLINE and Web of Science through January 2018. Twenty-two publications met inclusion criteria (total N = 61 985). Two random effects meta-analyses were conducted: (1) to identify the proportion of children and adolescents with ADHD that met criteria for ASD; and (2) to compare the severity of dimensionally-measured ASD symptomology in children and adolescents with and without ADHD. The overall pooled effect for children and adolescents with ADHD who met threshold for ASD was 21%. There was no significant difference between community samples (19%) and clinical samples (24%) or between US studies v. those from other countries. Children and adolescents with ADHD had substantially more dimensionally-measured ASD traits compared with those who did not have ADHD (d = 1.23). The findings provide further evidence that ADHD and ASD are associated in nature. Clinical and research implications are discussed.

Understanding and recognising the female phenotype of autism spectrum disorder and the “camouflage” hypothesis: a systematic PRISMA review

PurposeFemales with autism spectrum disorder (ASD) may display superficial social skills which may mask their ASD symptomology impacting on the identification of the disorder – known as the “camouflage” hypothesis. Compared to males with ASD, it is increasingly recognised that females with ASD have a stronger ability to imitate behaviour which is socially acceptable, particularly those females who have higher cognitive abilities (i.e. intelligence considered to be within the normal range) (Ehlers and Gillberg, 1993). The paper aims to discuss this issue.Design/methodology/approachThis paper will explore the literature on camouflaging or masking behaviour in females with ASD. A systematic PRISMA review was conducted.FindingsThe capacity to “camouflage” social difficulties in social situations is considered to be one of the main features of the female phenotype of ASD (e.g. Kenyon, 2014). Social imitation or camouflaging enables some level of success and coping, which results in some females never receiving a diagnosis of ASD. They typically may not exhibit any observable functional impairments. However, under the surface of the camouflage, females may experience high levels of subjective stress, anxiety and exhaustion and a need to re-charge or recuperate by withdrawing from any social interaction.Research limitations/implicationsThere is relatively little understanding and knowledge of the female phenotype of ASD. This lack of understanding and knowledge impacts significantly on the ability to identify females with ASD (Laiet al., 2015; Bargielaet al., 2016), which can have a number of negative consequence (Adamouet al., 2018; National Collaborating Centre for Mental Health (UK), 2012).Practical implicationsThere is a need for the development of a camouflaging measure.Originality/valueThere is a real need for further research exploring the positive and negative impact of the phenomenon of “camouflaging”, or “pretending to be normal” in females with ASD.

Oxytocin Receptors Are Expressed by Glutamatergic Prefrontal Cortical Neurons That Selectively Modulate Social Recognition

Social recognition, the ability to recognize individuals that were previously encountered, requires complex integration of sensory inputs with previous experience. Here, we use a variety of approaches to discern how oxytocin-sensitive neurons in the PFC exert descending control over a circuit mediating social recognition in mice. Using male mice with Cre-recombinase directed to the oxytocin receptor gene (Oxtr), we revealed that oxytocin receptors (OXTRs) are expressed on glutamatergic neurons in the PFC, optogenetic stimulation of which elicited activation of neurons residing in several mesolimbic brain structures. Optogenetic stimulation of axons in the BLA arising from OXTR-expressing neurons in the PFC eliminated the ability to distinguish novel from familiar conspecifics, but remarkably, distinguishing between novel and familiar objects was unaffected. These results suggest that an oxytocin-sensitive PFC to BLA circuit is required for social recognition. The implication is that impaired social memory may manifest from dysregulation of this circuit.SIGNIFICANCE STATEMENT Using mice, we demonstrate that optogenetic activation of the neurons in the PFC that express the oxytocin receptor gene (Oxtr) impairs the ability to distinguish between novel and familiar conspecifics, but the ability to distinguish between novel and familiar objects remains intact. Subjects with autism spectrum disorders (ASDs) have difficulty identifying a person based on remembering facial features; however, ASDs and typical subjects perform similarly when remembering objects. In subjects with ASD, viewing the same face increases neural activity in the PFC, which may be analogous to the optogenetic excitation of oxytocin receptor (OXTR) expressing neurons in the PFC that impairs social recognition in mice. The implication is that overactivation of OXTR-expressing neurons in the PFC may contribute to ASD symptomology.

The contributory role of autism symptomology in child pornography offending: why there is an urgent need for empirical research in this area

Purpose As recently highlighted by Creaby-Attwood and Allely (2017) it is crucial that the possible innate vulnerabilities that contributed to sexual offending behaviour in an individual with an autism spectrum disorder (ASD) are taken into consideration for the application of a diversion program to avoid the stigma of a criminal conviction or during sentencing for a non-custodial outcome. Specifically, in those defendants with a diagnosis of what used to be referred to as Asperger's Syndrome (AS) and now is recognised as an ASD and who are charged and convicted of a non-contact sexual offence, education and mental health intervention will best serve the interests of justice. Design/methodology/approach This paper focuses on one particular type of sexual offending behaviour, namely, possession of child pornography. A systematic PRISMA review was conducted. Findings The authors linked examples of child pornography in the research literature to the ASD symptomology and describe how the symptomology explains such behaviour as not reflecting actual sexual deviance. Originality/value Downloading and viewing of child pornography by individuals with ASD has received relatively little research outside the mental health field. This review is of particular importance to those in the criminal justice system who may not have much knowledge and understanding of ASD. It is suggested that diversion programmes and mental health courts should be set up for this particular population charged with this particular crime in mind so that the necessary treatment/intervention/support and care can be given to this particular group. Keywords: Autism Spectrum Disorder; Asperger’s syndrome; child pornography; child exploitative material; pretrial diversion

Early emergence of discrepancy in adaptive behavior and cognitive skills in toddlers with autism spectrum disorder.

Individuals with autism spectrum disorder and average IQ exhibit a widening discrepancy between lagging adaptive skills relative to their cognitive potential, but it is unknown when this discrepancy emerges in development. To address this important question, we measured adaptive and cognitive skills longitudinally, from 12-36 months, in 96 low-risk typically developing infants and 69 high-risk siblings of children with autism spectrum disorder who at 36 months were diagnosed with autism spectrum disorder (N = 21), the broader autism phenotype (N = 19), or showed no concerns (unaffected; N = 29). Results indicate that both cognitive and adaptive communication skills remained stable over time for all four groups, but toddlers with autism spectrum disorder and the broader autism phenotype failed to keep pace with unaffected and typically developing toddlers with regard to adaptive socialization skills and, to a lesser extent, daily living skills. The odds of having a discrepant developmental profile, with average cognitive skills and below average adaptive skills, was significantly greater for socialization and daily living skills in toddlers with autism spectrum disorder or the broader autism phenotype and increased over time from 12 to 36 months. The discrepancy between adaptive skills and cognition emerges early and widens over time for infants with autism spectrum disorder symptomology, supporting early assessment and intervention of adaptive socialization and daily living skills.

Distractor Inhibition in Autism Spectrum Disorder: Evidence of a Selective Impairment for Individuals with Co-occurring Motor Difficulties.

Although most researchers agree that individuals with Autism Spectrum Disorder (ASD) exhibit atypical attention, there is little consensus on the exact nature of their deficits. We explored whether attentional control in ASD varies as a function of motor proficiency. Nineteen children with ASD and 26 typically-developing controls completed the Movement Assessment Battery for Children and two ocular motor tasks requiring them to generate a saccade toward, and fixate, a visual target in the presence or absence of a distractor. The ASD group demonstrated poorer accuracy than typically-developing controls when distractors were present. Importantly, however, ASD symptomology was only related to poorer accuracy in individuals with motor difficulties. These findings suggest that distractor inhibition may be selectively impaired in this subgroup.

Superior Visual Search and Crowding Abilities Are Not Characteristic of All Individuals on the Autism Spectrum.

Individuals with Autism Spectrum Disorder (ASD) often excel on visual search and crowding tasks; however, inconsistent findings suggest that this 'islet of ability' may not be characteristic of the entire spectrum. We examined whether performance on these tasks changed as a function of motor proficiency in children with varying levels of ASD symptomology. Children with high ASD symptomology outperformed all others on complex visual search tasks, but only if their motor skills were rated at, or above, age expectations. For the visual crowding task, children with high ASD symptomology and superior motor skills exhibited enhanced target discrimination, whereas those with high ASD symptomology but poor motor skills experienced deficits. These findings may resolve some of the discrepancies in the literature.

Brief Report: Sex Differences in Parental Concerns for Toddlers with Autism Risk.

Research on sex differences in autism spectrum disorder (ASD) suggests both higher prevalence and a more easilyobservable presentation of core ASD symptomology in males, which may lead to sex differences in parental concerns. The current study examined whether sex and diagnosis relate to the timing, number, and types of pre-diagnosis concerns for 669 (Nmale=468) toddlers who screened atrisk for ASD. No sex differences in parents' concerns emerged for toddlers diagnosed with ASD; however, in the overall at-risk sample, parents of boys endorsed ASD symptoms, including restricted and repetitive behaviors, more than parents of girls. Future research should examine why sex differences in pre-diagnosis concerns emerge and how they might impact early diagnosis for at-risk boys versus girls.

Cortical responses before 6months of life associate with later autism.

Autism spectrum disorder (ASD) is a common, highly heritable, developmental disorder and later‐born siblings of diagnosed children are at higher risk of developing ASD than the general population. Although the emergence of behavioural symptoms of ASD in toddlerhood is well characterized, far less is known about development during the first months of life of infants at familial risk. In a prospective longitudinal study of infants at familial risk followed to 36 months, we measured functional near‐infrared spectroscopy (fNIRS) brain responses to social videos of people (i.e. peek‐a‐boo) compared to non‐social images (vehicles) and human vocalizations compared to non‐vocal sounds. At 4–6 months, infants who went on to develop ASD at 3 years (N = 5) evidenced‐reduced activation to visual social stimuli relative to low‐risk infants (N = 16) across inferior frontal (IFG) and posterior temporal (pSTS‐TPJ) regions of the cortex. Furthermore, these infants also showed reduced activation to vocal sounds and enhanced activation to non‐vocal sounds within left lateralized temporal (aMTG‐STG/pSTS‐TPJ) regions compared with low‐risk infants and high‐risk infants who did not develop ASD (N = 15). The degree of activation to both the visual and auditory stimuli correlated with parent‐reported ASD symptomology in toddlerhood. These preliminary findings are consistent with later atypical social brain responses seen in children and adults with ASD, and highlight the need for further work interrogating atypical processing in early infancy and how it may relate to later social interaction and communication difficulties characteristic of ASD.