Behavioral Markers Research Articles

Daily standing time, dietary fiber, and intake of unsaturated fatty acids are beneficially associated with hepatic insulin sensitivity in adults with metabolic syndrome.

Obesity is associated with impaired glucose metabolism and hepatic insulin resistance. The aim was to investigate the associations of hepatic glucose uptake (HGU) and endogenous glucose production (EGP) to sedentary behavior (SB), physical activity (PA), cardiorespiratory fitness, dietary factors, and metabolic risk markers. Forty-four adults with metabolic syndrome (mean age 58 [SD 7] years, BMI ranging from 25-40kg/; 25 females) were included. HGU was measured by positron emission tomography during the hyperinsulinemic-euglycemic clamp. EGP was calculated by subtracting the glucose infusion rate during clamp from the glucose rate of disappearance. SB and PA were measured with hip-worn accelerometers (26 [SD3] days). Fitness was assessed by maximal bicycle ergometry with respiratory gas measurements and dietary intake of nutrients by 4-day food diaries. HGU was not associated with fitness or any of the SB or PA measures. When adjusted for sex, age, and body fat-%, HGU was associated with whole-body insulin sensitivity (β=0.58), water-insoluble dietary fiber (β=0.29), energy percent (E%) of carbohydrates (β=-0.32), saccharose (β=-0.32), mono- and polyunsaturated fatty acids (β=0.35, β=0.41, respectively). EGP was associated with whole-body insulin sensitivity (β=-0.53), and low-density lipoprotein cholesterol [β=-0.31], and when further adjusted for accelerometry wear time, EGP was associated with standing [β=-0.43]. (p-value for all< 0.05). Standing more, consuming a diet rich in fiber and unsaturated fatty acids, and a lower intake of carbohydrates, especially sugar, associate beneficially with hepatic insulin sensitivity. Habitual SB, PA, or fitness may not be the primary modulators of HGU and EGP. However, these associations need to be confirmed with intervention studies.

Implicit measures of suicide vulnerability: Investigating suicide-related information-processing biases and a deficit in behavioral impulse control in a high-risk sample and healthy controls

ObjectiveRelevant implicit markers of suicidal thoughts and behaviors (STBs) have only been studied in isolation with mixed evidence. This is the first study that investigated a suicide attentional bias, a death-identity bias and a deficit in behavioral impulsivity in a high-risk sample and healthy controls. MethodWe administered the Death Implicit Association Test, the Modified Suicide Stroop Task, and a Go/No-Go Task to inpatient suicide ideators (n = 42), suicide attempters (n = 40), and community controls (n = 61). ResultsSuicide ideators and attempters showed a suicide attentional bias and a death-identity bias compared to healthy controls. Ideators and attempters did not differ in these implicit information-processing biases. Notably, only attempters were more behaviorally impulsive compared to controls; however, ideators and attempters did not significantly differ in behavioral impulsivity. Moreover, implicit scores were positively intercorrelated in the total sample. ConclusionIn line with the Cognitive Model of Suicide, ideators and attempters display suicide-related information processing biases, which can be considered as implicit cognitive markers of suicide vulnerability. Furthermore, attempters have elevated levels of behavioral impulsiveness. These results are highly relevant in the context of crisis intervention strategies and warrant further research.

Bi-lingual content validation of the Non-Technical Skills for Operating Room Nurses (NOTSORN) tool: A Delphi study

BackgroundThe primary responsibility of the operating room nurse is to prevent adverse events and patient harm during surgery. Since most preventable adverse events are the result of breakdowns in communication and teamwork, or non-technical skills, training such skills should strengthen the operating room nurses’ error prevention abilities. Behavioural marker systems operationalise non-technical skills; however, previous systems for operating room nurses do not cover the full extent of non-technical skills used by operating room nurses. Thus, the Non-technical Skills for Operating Room Nurses (NOTSORN) behavioural marker system was developed. ObjectiveThe objective of this study was to establish face and content validity of the Non-Technical Skills for Operating Room Nurses behavioural marker system. This multi-item scale measures individual non-technical skills in operating room nursing. ParticipantsA purposive sample of operating room nursing researchers, educators, and senior clinicians from nine countries worldwide. MethodsA two round, Delphi panel with international experts in operating room nursing. The survey was administered online. Content validity index (CVI) was used to measure agreement among panel members. Results25 operating room nurse experts participated in the online Delphi study. After round 1, 56 items were accepted, 26 items were revised, and 1 item was dropped. Following round 2, all items (6 with minor revisions) were accepted. Thus, the Non-technical Skills for Operating Room Nurses tool comprise 81 items. The scale level CVI score for the final 81 item tool was 0.99. The individual item level CVI scores ranged from 0.9 to 1.0. ConclusionsThe Non-Technical Skills of Operating Room Nurses behavioural marker system is a nuanced tool with a myriad of non-technical skills operating room nurses need to undertake their work safely. The tool's intended use includes student/trainee supervision, supervision of novice operating room nurses, self-reflection for performance reports, and in operating room nursing education. Over time, use of the tool has the potential to contribute to patient safety in the operating room. Tweetable abstractThe NOTSORN tool provides a comprehensive and holistic evaluation of OR nurses' non-technical skills for safe surgical performance

Study of the neuroprotective properties of the heteroreceptor EPOR/CD131 agonist of peptide structure in tau-proteinopathy modeling

Introduction: Tau proteinopathy is a pathology associated with the activation of post-translational modifications and interactions of pathophysiological cascades of neuroinflammation with hyperphosphorylation of Tau aggregates. Therefore, preference is given to agents that have properties in reducing or slowing down the processes of neuroinflammation and post-translational modifications in the brain. Materials and Methods: The study was conducted on male and female homozygous individuals of a transgenic murine line with overexpression of mutant human Tau gene (P301S) and a background wild mouse line C57Bl/6J. To assess the progression of Tau proteinopathy, behavioral tests were used at two control time points, and the last one measured the level of neuroinflammation markers and tau-proteinopathy. Results and Discussion: In the group of P301S mice treated with ARA-290, an improvement in the phenotypic picture of Tau proteinopathy was demonstrated compared with intact animals. In the Barnes circular maze test, mice showed a decrease in the total distance traveled and the latent time spent on the platform, which indicates a rapid entry into the shelter. In the O-shaped maze test, the group maintained a fairly high level of spontaneous exploratory behavior. In the vertical rod test, the animals recorded the best time indicators that they needed to turn and maintain balance compared to the intact group. A statistically significant decrease in the level of GSK-3β and an increase in CDK5 and PP2A were revealed, which indicates a dephosphorylating effect on Tau protein, as well as markers of neuroinflammation. NF-KB and TNF-α were significantly reduced by 57% and 32%, respectively, compared to the intact group. Conclusion: In the model of transgenic P301S murine line with overexpression of the mutant human Tau gene, the peptide agonist of the EPOR/CD 131 heteroreceptor demonstrated neuroprotective properties, which were confirmed by indicators of behavioral tests and markers of neuroinflammation and tau-proteinopathy.

The relationship between neural processing efficiency during inter-hemispheric transfer, alcohol consumption, and sleep quality in college students: an ERP study

Objective: To examine relationships between sleep, alcohol consumption, and a physiological and behavioral marker of cognitive function in college students. College students are in a high risk category for high alcohol consumption and poor sleep quality, two unhealthful behaviors which can lead to poor mental health outcomes and compromised academic performance. Participants: Thirty college students from a large midwestern institution. Methods: Participants performed an interhemispheric transfer task while their electroencephalography was recorded for later examination of event-related potentials. They were also administered the Pittsburgh Sleep Quality Index, the Alcohol Use Disorders Identification Test, and the Alcohol Timeline Follow-Back. Results: Results demonstrate that increased alcohol consumption is associated with poor right-to-left interhemispheric transfer performance, and increased frontal P1 ERP amplitudes to neuro-ipsilateral targets requiring an interhemispheric-transfer. Conclusions: These findings assist in furthering explorations into the impacts of unhealthy behaviors in college students and underlying markers of simple cognitive and behavioral function.

The Role of Anatomic Connectivity in Inhibitory Control Revealed by Combining Connectome-based Lesion-symptom Mapping with Event-related Potentials.

Inhibitory control refers to the ability to suppress cognitive or motor processes. Current neurocognitive models indicate that this function mainly involves the anterior cingulate cortex and the inferior frontal cortex. However, how the communication between these areas influence inhibitory control performance and their functional response remains unknown. We addressed this question by injecting behavioral and electrophysiological markers of inhibitory control recorded during a Go/NoGo task as the 'symptoms' in a connectome-based lesion-symptom mapping approach in a sample of 96 first unilateral stroke patients. This approach enablesus to identify the white matter tracts whose disruption by the lesions causally influences brain functional activity during inhibitory control. We found a central role of left frontotemporal and frontobasal intrahemispheric connections, as well as of the connections between the left temporoparietal and right temporal areas in inhibitory control performance. We also found that connections between the left temporal and right superior parietal areas modulate the conflict-related N2 event-related potential component and between the left temporal parietal area and right temporal and occipital areas for the inhibition P3 component. Our study supports the role of a distributed bilateral network in inhibitory control and reveals that combining lesion-symptom mapping approaches with functional indices of cognitive processes could shed new light on post-stroke functional reorganization. It may further help to refine the interpretation of classical electrophysiological markers of executive control in stroke patients.

Combining supervised and unsupervised analyses to quantify behavioral phenotypes and validate therapeutic efficacy in a triple transgenic mouse model of Alzheimer's disease.

Behavioral testing is an essential tool for evaluating cognitive function and dysfunction in preclinical research models. This is of special importance in the study of neurological disorders such as Alzheimer's disease. However, the reproducibility of classic behavioral assays is frequently compromised by interstudy variation, leading to ambiguous conclusions about the behavioral markers characterizing the disease. Here, we identify age- and genotype-driven differences between 3xTg-AD and non-transgenic control mice using a low-cost, highly customizable behavioral assay that requires little human intervention. Through behavioral phenotyping combining both supervised and unsupervised behavioral classification methods, we are able to validate the preventative effects of the immunosuppressant cyclosporine A in a rodent model of Alzheimer's disease, as well as the partially ameliorating effects of candidate drugs nebivolol and cabozantinib.

Exploring the mechanism of enterotoxicity mediated by the microbiome-butyrate-PPAR axis in podophyllotoxin through the toxicological evidence chain (TEC) concept

Podophyllotoxin (PPT) is a lignan derived from the roots and stems of the Podophyllum plant. However, its enterotoxicity restricts its clinical application. The underlying mechanisms by which PPT exerts its action remain largely elusive. This study aimed to evaluate the molecular mechanisms underlying PPT-induced enterotoxicity utilizing the concept of toxicological evidence chain. Changes in body weight, behavior, and histopathological and biochemical markers in rats were observed. Additionally, microbiome, metabolome, and transcriptome analyses were integrated to identify potential microorganisms, metabolic markers, and major pathways using a co-occurrence network. Our findings suggested that PPT induced pathological changes in rats, including weight loss, diarrhea, and inflammation accompanied by increased levels of IFN-γ, IL-5, IL-6, GRO/KC, and IL-12p70. The decrease in butyrate levels in the PPT group may be related to the enrichment of Firmicutes. The reduction of butyrate levels may impair the expression of PPARγ, subsequently promoting Escherichia-Shigella proliferation. Additionally, the suppression of PPARs pathway may result in the increased production of inflammatory factors, contributing to enterotoxicity. This study offers a novel understanding of the molecular mechanisms underlying PPT-induced enterotoxicity, making a significant contribution to developing strategies to mitigate PPT toxicity and prevent associated diseases.

Consistency within change: Evaluating the psychometric properties of a widely used predictive-inference task

Rapid adaptation to sudden changes in the environment is a hallmark of flexible human behaviour. Many computational, neuroimaging, and even clinical investigations studying this cognitive process have relied on a behavioural paradigm known as the predictive-inference task. However, the psychometric quality of this task has never been examined, leaving unanswered whether it is indeed suited to capture behavioural variation on a within- and between-subject level. Using a large-scale test–retest design (T1: N = 330; T2: N = 219), we assessed the internal (internal consistency) and temporal (test–retest reliability) stability of the task’s most used measures. We show that the main measures capturing flexible belief and behavioural adaptation yield good internal consistency and overall satisfying test–retest reliability. However, some more complex markers of flexible behaviour show lower psychometric quality. Our findings have implications for the large corpus of previous studies using this task and provide clear guidance as to which measures should and should not be used in future studies.

Ingestible pills reveal gastric correlates of emotions.

Although it is generally held that gastrointestinal (GI) signals are related to emotions, direct evidence for such a link is currently lacking. One of the reasons why the internal milieu of the GI system is poorly investigated is because visceral organs are difficult to access and monitor. To directly measure the influence of endoluminal markers of GI activity on the emotional experience, we asked a group of healthy male participants to ingest a pill that measured pH, pressure, and temperature of their GI tract while they watched video clips that consistently induced disgust, fear, happiness, sadness, or a control neutral state. In addition to the objective physiological markers of GI activity, subjective ratings of perceived emotions and visceral (i.e. gastric, respiratory and cardiac) sensations were recorded, as well as changes in heart rate (HR), heart rate variability (HRV) and spontaneous eyes blinks as non-gastric behavioral and autonomic markers of the emotional experience. We found that when participants observed fearful and disgusting video clips, they reported to perceive not only cardiac and respiratory sensations but also gastric sensations, such as nausea. Moreover, we found that there was a clear relation between the physiology of the stomach and the perceived emotions. Specifically, when disgusting video clips were displayed, the more acidic the pH, the more participants reported feelings of disgust and fear; the less acidic the pH, the more they reported happiness. Complementing the results found in the deep gastric realm, we found that disgusting stimuli induced a significant increase in HRV compared to the neutral scenarios, and together with fearful video clips a decrease in HR. Our findings suggest that gastric signals contribute to unique emotional states and that ingestible pills may open new avenues for exploring the deep-body physiology of emotions.

Research Paper on Transformative Innovations in Identity Verification and Recognition

Integrating real-time human detection into identity authentication greatly improves both security and user experience. This strategy decreases fraud risk by analysing physiological and behavioural markers such as facial and eye movements. Its implementation in financial, healthcare, e-commerce, and law enforcement sectors promise to strengthen security measures. Although obstacles exist, the benefits of this human-centered approach are significant, paving the path for a safer digital future. Keywords: Identity verification, biometric authentication, digital security, real-time human detection, fraud prevention, user experience, computer vision, physiological and behavioural clues, facial and vocal patterns, banking, healthcare, e-commerce, law enforcement.

Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury

Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale–Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70–40.32), P < 0.001; and 2.9 (1.56–5.45), P < 0.001, respectively). Moreover, increasing the number of assessment modalities decreased uncertainty (OR = 0.35 (0.21–0.59), P < 0.001) and improved prognostic accuracy (OR = 2.72 (1.18–6.47), P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients. ClinicalTrials.gov registration: NCT04534777.

Digital phenotyping data and anomaly detection methods to assess changes in mood and anxiety symptoms across a transdiagnostic clinical sample.

Clinical assessment of mood and anxiety change often relies on clinical assessment or self-reported scales. Using smartphone digital phenotyping data and resulting markers of behavior (e.g., sleep) to augment clinical symptom scores offers a scalable and potentially more valid method to understand changes in patients' state. This paper explores the potential of using a combination of active and passive sensors in the context of smartphone-based digital phenotyping to assess mood and anxiety changes in two distinct cohorts of patients to assess the preliminary reliability and validity of this digital phenotyping method. Participants from two different cohorts, each n = 76, one with diagnoses of depression/anxiety and the other schizophrenia, utilized mindLAMP to collect active data (e.g., surveys on mood/anxiety), along with passive data consisting of smartphone digital phenotyping data (geolocation, accelerometer, and screen state) for at least 1 month. Using anomaly detection algorithms, we assessed if statistical anomalies in the combination of active and passive data could predict changes in mood/anxiety scores as measured via smartphone surveys. The anomaly detection model was reliably able to predict symptom change of 4 points or greater for depression as measured by the PHQ-9 and anxiety as measured for the GAD-8 for both patient populations, with an area under the ROC curve of 0.65 and 0.80 for each respectively. For both PHQ-9 and GAD-7, these AUCs were maintained when predicting significant symptom change at least 7 days in advance. Active data alone predicted around 52% and 75% of the symptom variability for the depression/anxiety and schizophrenia populations respectively. These results indicate the feasibility of anomaly detection for predicting symptom change in transdiagnostic cohorts. These results across different patient groups, different countries, and different sites (India and the US) suggest anomaly detection of smartphone digital phenotyping data may offer a reliable and valid approach to predicting symptom change. Future work should emphasize prospective application of these statistical methods.

Chinese Bayberry Extract Regulates the Permeability of Blood-cerebrospinal Fluid Barrier and Ameliorates Experimental Colitis-Related Brain Comorbidities in Mice

Abstract Objectives The anxiety, depression symptoms, and cognitive decline related to inflammatory bowel disease (IBD) are recognized to have an impact on patients’ health. The blood-cerebrospinal fluid barrier (BCSFB) is important in somatic disease-related psychiatric and cognitive disorders, however, few treatments show efficacy. The objective of this research was to seek the protective effect of Chinese bayberry extract on inflammatory bowel disease-related brain comorbidities. Materials and Methods C57BL/6J mice were induced with dextran sulfate sodium (DSS) solution to establish the experimental model, followed by the administration of Chinese bayberry extract. Oxidative stress indexes, immunofluorescence of choroid plexus, and BCSFB permeability were further investigated. Results Chinese bayberry extract improved behavioral markers and reduced the level of oxidative stress in the brain. In addition, administration of the bayberry extract increased the tight junction proteins in the choroid plexus and a significant decrease in the permeability of the BCSFB. Conclusions Chinese bayberry extract has the potential therapeutic effect of relieving inflammatory bowel disease-related brain comorbidities. The underlying mechanism is associated with a decrease in oxidative stress in the brain and a decrease in the permeability of the BCSFB.

Miscommunication in Stillwater: The Interplay of Social Identities, Language Barriers, and Emotional Dynamics

This paper analyses Stillwater&amp;rsquo;s (2021) dialogue and action lines to demonstrate how miscommunication, specifically during heightened emotional instances, between Bill, the protagonist, and other characters is due to language barriers and emotional dynamics related to ethnic diversity. The study reveals that language difficulties hinder effective communication between Bill, an out-group member, and French residents, the in-group. Consequently, his limited language skills not only mark him as an outsider by challenging his efforts to integrate into the French culture, but also prove that language is a marker of group identity, influencing emotions, behavior, and interaction. In addition, the study demonstrates that the cultural disparities Bill encounters socially define and categorize him as an &amp;ldquo;out-group&amp;rdquo; member (American) from the perspective of the &amp;ldquo;in-group&amp;rdquo; (French), thus elucidating out-group biases and discrimination. These findings emphasize the role of language in reflecting linguistic and cultural nuances in intergroup interactions in the screenplay Stillwater.

Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder.

Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis. To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns. Observational cohort longitudinal design using blinded video analysis. Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age. Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = -2.29, p < .05, r = .31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD. Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD.

Heuristics in risky decision-making relate to preferential representation of information

When making choices, individuals differ from one another, as well as from normativity, in how they weigh different types of information. One explanation for this relates to idiosyncratic preferences in what information individuals represent when evaluating choice options. Here, we test this explanation with a simple risky-decision making task, combined with magnetoencephalography (MEG). We examine the relationship between individual differences in behavioral markers of information weighting and neural representation of stimuli pertinent to incorporating that information. We find that the extent to which individuals (N = 19) behaviorally weight probability versus reward information is related to how preferentially they neurally represent stimuli most informative for making probability and reward comparisons. These results are further validated in an additional behavioral experiment (N = 88) that measures stimulus representation as the latency of perceptual detection following priming. Overall, the results suggest that differences in the information individuals consider during choice relate to their risk-taking tendencies.

10 Hz rhythmic stimulation modulates electrophysiological, but not behavioral markers of suppression.

We investigated the role of alpha in the suppression of attention capture by salient but to-be-suppressed (negative and nonpredictive) color cues, expecting a potential boosting effect of alpha-rhythmic entrainment on feature-specific cue suppression. We did so by presenting a rhythmically flickering visual bar of 10 Hz before the cue - either on the cue's side or opposite the cue -while an arrhythmically flickering visual bar was presented on the respective other side. We hypothesized that rhythmic entrainment at cue location could enhance the suppression of the cue. Testing 27 participants ranging from 18 to 39 years of age, we found both behavioral and electrophysiological evidence of suppression: Search times for a target at a negatively cued location were delayed relative to a target away from the cued location (inverse validity effects). In addition, an event-related potential indicative for suppression (the Distractor Positivity, Pd) was observed following rhythmic but not arrhythmic stimulation, indicating that suppression was boosted by the stimulation. This was also echoed in higher spectral power and intertrial phase coherence of EEG at rhythmically versus arrhythmically stimulated electrode sites, albeit only at the second harmonic (20 Hz), but not at the stimulation frequency. In addition, inverse validity effects were not modulated by rhythmic entrainment congruent with the cue side. Hence, we propose that rhythmic visual stimulation in the alpha range could support suppression, though behavioral evidence remains elusive, in contrast to electrophysiological findings.

Validation of the brief screening of Social Network Addiction Risk

IntroductionThis study aims to develop a valid and reliable tool to evaluate social network behavior in young adults. MethodsTo validate the Brief screening for Social Network Addiction Risk (BSNA), data from 776 Italian young adults (64.3 % of women) were collected. The suitability of the instrument was statistically assessed. Experts' opinions, item reliability, exploratory and confirmatory factor analyses, and convergent validity were adopted to validate the BSNA items. Internal consistency coefficients were also calculated. ResultsAccording to the statistical analyses, a 2-factor structure was confirmed. The two scales of BSNA assess behavior and motivation frame of social networks use. The second order model proved a global score of risk of social network addiction. Fit indices highlighted the high goodness of the model. Preliminary analyses of prevalence estimated that about 18 % of participants reported problematic Social Network use, which may overtime represent a marker of addictive behavior. ConclusionThe final version of the BSNA, with 11 items evaluated on a 5-point Likert- scale, is a short but valid tool for measuring the risk of social network addiction. It represents a promising screening tool aimed to not overpathologize a behavior, but to furnish adequate insight into this phenomenon.

Exploring early life social and executive function development in infants and risk for autism: a prospective cohort study protocol of NICU graduates and infants at risk for cerebral palsy

BackgroundDelays in early social and executive function are predictive of later developmental delays and eventual neurodevelopmental diagnoses. There is limited research examining such markers in the first year of life. High-risk infant groups commonly present with a range of neurodevelopmental challenges, including social and executive function delays, and show higher rates of autism diagnoses later in life. For example, it has been estimated that up to 30% of infants diagnosed with cerebral palsy (CP) will go on to be diagnosed with autism later in life.MethodsThis article presents a protocol of a prospective longitudinal study. The primary aim of this study is to identify early life markers of delay in social and executive function in high-risk infants at the earliest point in time, and to explore how these markers may relate to the increased risk for social and executive delay, and risk of autism, later in life. High-risk infants will include Neonatal Intensive Care Unit (NICU) graduates, who are most commonly admitted for premature birth and/or cardiovascular problems. In addition, we will include infants with, or at risk for, CP. This prospective study will recruit 100 high-risk infants at the age of 3–12 months old and will track social and executive function across the first 2 years of their life, when infants are 3–7, 8–12, 18 and 24 months old. A multi-modal approach will be adopted by tracking the early development of social and executive function using behavioural, neurobiological, and caregiver-reported everyday functioning markers. Data will be analysed to assess the relationship between the early markers, measured from as early as 3–7 months of age, and the social and executive function as well as the autism outcomes measured at 24 months.DiscussionThis study has the potential to promote the earliest detection and intervention opportunities for social and executive function difficulties as well as risk for autism in NICU graduates and/or infants with, or at risk for, CP. The findings of this study will also expand our understanding of the early emergence of autism across a wider range of at-risk groups.